ZipRecruiter

Log In

1

Credentialing Manager Jobs in Clive, IA (NOW HIRING)

STATUS Health Partners

Be Seen First

Credentialer - Entry Level

Ankeny, IA · On-site

... credentialing, physician verification, and staffing/placement. Our need... A growing health care ... management skills. The "Perks" Full benefits package. STATUS offers health, dental and vision ...

next page

Showing results 1-20

All JobsCredentialing JobsCredentialing Manager JobsCredentialing Manager Jobs in Clive, IA

Credentialing Manager information

See Clive, IA salary details

$42.6K

$83.3K

$128.8K

How much do credentialing manager jobs pay per year?

As of Sep 6, 2026, the average yearly pay for credentialing manager in Clive, IA is $83,291.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,700.00 and $92,600.00 per year, depending on experience, location, and employer.

What is a credentialing manager?

Credentialing Managers are professionals responsible for overseeing the process of verifying the qualifications, licenses, and background of healthcare providers before they are allowed to work with patients or participate in insurance networks. They ensure that all providers meet regulatory and organizational standards, and maintain up-to-date records for compliance purposes. Credentialing Managers often work in hospitals, healthcare organizations, or insurance companies, collaborating with medical staff, administrators, and external agencies to manage and streamline the credentialing process.

What does a credentialing manager do?

A credentialing manager monitors the credential status of employees and ensuring they are recertified when necessary. As a credentialing manager, your job duties involve maintaining a database of employee certifications and renewal dates, confirming that employee credentials match the requirements of their job, and helping employees renew their credentials on time by finding test dates and locations. Credentialing managers are most commonly found in the health care industry. Qualifications to become a medical credentialing manager include a bachelor’s degree in human resources, business, or a related field, and industry experience.

What are the key skills and qualifications needed to thrive as a credentialing manager?

To thrive as a Credentialing Manager, you need thorough knowledge of healthcare credentialing processes, compliance standards, and experience with provider enrollment, often supported by a bachelor's degree in healthcare administration or a related field. Familiarity with credentialing software systems like CACTUS or Verity, and understanding of regulatory requirements such as NCQA or The Joint Commission, are typically expected. Attention to detail, strong organizational skills, and effective communication are standout soft skills for this position. These competencies ensure accurate and efficient management of provider credentials, minimize compliance risks, and maintain quality standards within healthcare organizations.

What are some common challenges a credentialing manager faces when maintaining compliance with changing regulations?

Credentialing Managers often encounter the challenge of staying updated with frequently changing industry regulations and payer requirements, which can vary by state and organization. Ensuring that all provider files are consistently accurate and compliant requires diligent monitoring, regular audits, and ongoing staff training. Additionally, coordinating with multiple departments and external agencies to gather necessary documentation while meeting tight deadlines can be demanding. Proactively implementing process improvements and leveraging credentialing software can help manage these complexities effectively.

What is the difference between Credentialing Manager vs Credentialing Specialist?

AspectCredentialing ManagerCredentialing Specialist
ResponsibilitiesOversees entire credentialing process, manages teams, develops policiesPerforms credentialing tasks, verifies credentials, maintains records
Required CredentialsTypically requires experience in healthcare administration, certifications like Certified Provider Credentialing Specialist (CPCS)Often requires similar certifications, entry to mid-level experience
Work EnvironmentManagement level, strategic planning, team supervisionOperational, detail-oriented, administrative tasks
Industry UsageUsed across healthcare organizations, hospitals, clinicsCommonly found in healthcare facilities, physician practices

The Credentialing Manager focuses on overseeing the entire credentialing process, managing teams, and developing policies, while the Credentialing Specialist handles day-to-day credential verification and record maintenance. Both roles require relevant certifications and healthcare industry experience, but the manager role involves more strategic oversight.

More about Credentialing Manager jobs

What cities near Clive, IA are hiring for Credentialing Manager jobs?

Cities near Clive, IA with the most Credentialing Manager job openings:

Credentialing Manager jobs near you
Infographic showing various Credentialing Manager job openings in Clive, IA as of August 2026, with employment types broken down into 10% Locum Tenens, 80% Full Time, 5% Part Time, and 5% Contract. Highlights an 95% In-person, and 5% Remote job distribution, with an average salary of $83,291 per year, or $40 per hour.

NCQA Project/Program Manager

Blue Cross and Blue Shield of North Carolina

Des Moines, IA • On-site

Other

Medical, Dental, Vision, Retirement, PTO

Posted 9 days ago

Blue Cross and Blue Shield of North Carolina rating

7.8

Company rating: 7.8 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

197th of 315 rated insurance

Job description

Job Description

We're hiring a National Committee Quality Assurance (NCQA) Project/Program Manager to lead our Health Plan Accreditation activities with a primary focus on Member Experience and Credentialing standards. This role drives organizational readiness, ensures ongoing compliance, and partners cross-functionally to support successful NCQA survey outcomes. The ideal candidate brings strong experience in NCQA accreditation and credentialing oversight.

What You'll Do

  • Serve as the organizational lead for NCQA Credentialing and Recredentialing (CR) standards, ensuring policies, procedures, files, and oversight activities meet accreditation requirements.

  • Lead annual NCQA readiness assessments and mock surveys for Credentialing, Member Experience, and other accreditation standards to ensure continuous survey readiness.

  • Support oversight of credentialing delegates and vendors, including performance monitoring, annual audits, corrective action plans, and reporting to credentialing governance committees.

  • Partner with Credentialing Operations, Network Management, other business areas and delegated entities to ensure ongoing compliance with NCQA CR standards and credentialing-related regulatory requirements.

  • Lead preparation for and participation in NCQA Credentialing File Reviews, including file selection, audit readiness assessments, corrective actions, and survey response development.

  • Lead planning, execution, and oversight of NCQA Health Plan Accreditation programs, ensuring alignment with organizational goals and timelines

  • Develop and maintain the NCQA program work plan and tracking tools to monitor progress, risks, and compliance status

  • Coordinate NCQA survey activities, including documentation management, submission readiness, and stakeholder engagement

  • Serve as subject matter expert (SME) on NCQA standards, with emphasis on Member Experience and Credentialing/Recredentialing (CR)

  • Interpret standards and partner with business owners to operationalize requirements and implement compliant processes

  • Identify gaps and risks; develop mitigation strategies and provide regular status reporting to leadership

  • Conduct ongoing readiness reviews, audits, and monitoring activities to ensure sustained compliance

  • Collaborate with business areas and cross-functional stakeholders to develop and finalize NCQA data source submission reports (e.g., Member Experience [ME 7]), ensuring accuracy, completeness, and alignment with NCQA standards and audit expectations

  • Oversee delegated vendor functions to ensure adherence to NCQA accreditation requirements

  • Facilitate cross-functional workgroups, committee discussions, and Quality Improvement meetings to drive accountability and readiness

  • Establish and track performance metrics (process, outcome, and compliance measures) and present findings to stakeholders

  • Drive continuous improvement initiatives to enhance quality, efficiency, and accreditation outcomes

  • Analyze policies, workflows, and documentation to improve effectiveness and ensure regulatory alignment

  • Support additional accreditation and compliance initiatives as needed

What You Bring

  • Bachelor's degree or equivalent experience

  • 3+ years of experience in related field

  • In lieu of degree, 5+ years of experience in related field

Bonus Points (preferred qualifications)

  • 5+ years of program or project management experience in healthcare, quality, or compliance

  • Demonstrated experience preparing for and supporting NCQA surveys, file reviews, and accreditation submissions.

  • Strong working knowledge of health plan credentialing operations, delegated credentialing oversight, and provider network compliance requirements.

  • Experience leading cross-functional accreditation workgroups and driving corrective action plans through completion.

  • Direct experience with NCQA Health Plan Accreditation standards and survey processes

  • Experience supporting or managing Credentialing and Recredentialing (CR) activities

  • Proven ability to manage cross-functional initiatives and drive results in a matrixed environment

  • Strong understanding of accreditation compliance, evidence documentation, and audit readiness

  • Ability to assess compliance gaps and implement actionable solutions

  • Excellent analytical, organizational, and problem-solving skills

  • Strong communication skills with the ability to influence stakeholders at all levels

  • Proficiency in Microsoft Excel, PowerPoint, Teams, and SharePoint

  • High attention to detail with strong program tracking and reporting capabilities

WhatYou'llGet

  • The opportunity to work at thecutting edgeof health care delivery with a teamthat'sdeeply invested in the communityWork-life balance, flexibility, and the autonomy to dogreat work

  • Medical, dental, and vision coverage along withnumeroushealth and wellness programs

  • Parental leave and support plus adoption and surrogacyassistance

  • Career development programs and tuition reimbursement for continued education

  • 401k match including an annual company contribution

  • Learn more

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$73,698.00 - $117,917.00

Skills

Budgeting, Office Administration, Process Improvements, Program Administration, Program Documentation, Program Evaluations, Program Implementation, Program Management, Project Management, Resource Allocation

_____________________________________________________________________
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

What Blue Cross and Blue Shield of North Carolina employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply