Manager, Provider Credentialing- Charlotte, NC

At OrthoCarolina, our team is our greatest asset and the foundation of our success. We are a diverse group of individuals, accountable to each other to uphold the standards of excellence and promote an environment of teamwork throughout the organization.  OrthoCarolina has 43 unique care locations with over 1300 professionals who share a common goal to make lives better. Our employees are eligible for a full spectrum of benefits including paid company holidays, wellness programs, and tuition reimbursement. To learn more about Team OC please visit https://www.orthocarolina.com/about-us

OrthoCarolina is seeking a Manager of Provider Support Services to join our Provider Credentialing team in Charlotte, NC.

The Manager, Provider Support Services is responsible for the strategic leadership, operational management, compliance oversight, and continuous improvement of provider credentialing, delegated credentialing, payer enrollment, privileging, onboarding, provider data management, training, audit readiness, and provider support services.

Essential Functions:

·        Lead, coach, and develop the Provider Support Services team, ensuring accountability for quality, productivity, compliance, and service.

·        Oversee provider credentialing, recredentialing, primary source verification, payer enrollment, privileging, onboarding, and delegated credentialing activities.

·        Manage delegated credentialing programs, payer relationships, audits, reporting requirements, and corrective action plans.

·        Ensure compliance with payer, regulatory, accreditation, and organizational requirements.

·        Monitor department performance, workloads, timelines, and key performance indicators to ensure operational goals are achieved.

·        Partner with providers, leadership, hospitals, payers, Revenue Cycle, Managed Care, Compliance, HR, IT, and Operations to resolve issues and support provider readiness.

·        Identify and implement process improvements to increase efficiency, data accuracy, and service delivery.

Skills and Abilities:

·        Strong leadership, coaching, and team development skills.

·        Excellent organizational skills with the ability to manage multiple priorities and deadlines.

·        Strong knowledge of credentialing, payer enrollment, delegated credentialing, privileging, and healthcare compliance requirements.

·        Demonstrated problem-solving, critical-thinking, and process-improvement abilities.

·        Strong interpersonal and communication skills with the ability to collaborate across departments and with external partners.

·        Advanced proficiency in Microsoft Excel and experience with Microsoft Teams, SharePoint, Outlook, Word, credentialing systems, and provider databases.

·         Ability to analyze data, develop reports and dashboards, and monitor operational performance.

Qualifications:

·        Bachelor’s degree in Healthcare Administration, Business Administration, Human Resources, or a related field preferred; equivalent education and relevant experience may be considered.

·        5+ years of progressively responsible experience in credentialing, provider enrollment, medical staff services, or healthcare operations.

·        3+ years of management, supervisory, or team leadership experience.

·        Experience managing credentialing and provider enrollment functions within a healthcare organization.

·        Experience with delegated credentialing arrangements, payer audits, performance metrics, and operational improvement initiatives strongly preferred.

Employee Type

Qualifications

Skills

Education

Certifications

Language

Work Experience