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Credentials Manager Jobs in Pennsylvania (NOW HIRING)

WellSpan Health

Credentialing Coordinator

York, PA · On-site

General Summary Maintains close communication with providers, practice managers and the medical staff office to ensure timely initial credentialing, recredentialing and reappointments through the ...

Merakey

Credentialing Specialist

Lafayette Hill, PA · Remote

$21/hr

Verifying that candidate credentials are in compliance with program, State and Federal standards. * Effectively communicating with Program Management and Staffing Partners on a regular basis ...

Elwyn

Credentialing Coordinator QI

Media, PA

Collaborates with Human Resources and operations management personnel to maintain an up to date ... Provides credentialing documentation to the Office of Licensing personnel during Administrative ...

Elwyn

Credentialing Coordinator QI

Media, PA · On-site

Collaborates with Human Resources and operations management personnel to maintain an up to date ... Provides credentialing documentation to the Office of Licensing personnel during Administrative ...

Elwyn

Credentialing Coordinator QI

Media, PA

Collaborates with Human Resources and operations management personnel to maintain an up to date ... Provides credentialing documentation to the Office of Licensing personnel during Administrative ...

Elwyn

Credentialing Coordinator QI

Media, PA

Collaborates with Human Resources and operations management personnel to maintain an up to date ... Provides credentialing documentation to the Office of Licensing personnel during Administrative ...

Elwyn

Credentialing Coordinator QI

Media, PA

Collaborates with Human Resources and operations management personnel to maintain an up to date ... Provides credentialing documentation to the Office of Licensing personnel during Administrative ...

Elwyn

Credentialing Coordinator QI

Media, PA · On-site

Collaborates with Human Resources and operations management personnel to maintain an up to date ... Provides credentialing documentation to the Office of Licensing personnel during Administrative ...

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Credentials Manager information

What is a credentials manager?

A Credentials Manager is a professional responsible for overseeing, maintaining, and securing access credentials such as passwords, certificates, and digital keys within an organization. Their role typically involves implementing policies and systems that ensure only authorized individuals can access sensitive information or systems. They may use credential management software to automate password changes, monitor usage, and enforce security protocols. Credentials Managers play a critical role in protecting an organization's data and preventing unauthorized access.

What skills and qualifications are needed to thrive as a credentials manager?

To thrive as a Credentials Manager, you need strong organizational skills, attention to detail, and a solid understanding of compliance and credentialing processes, often supported by a degree in business administration or a related field. Familiarity with credentialing software systems, databases, and knowledge of industry standards such as NCQA or Joint Commission requirements is essential. Excellent communication, problem-solving abilities, and discretion are valuable soft skills for managing sensitive information and coordinating with diverse stakeholders. These skills ensure accurate credential management, regulatory compliance, and smooth operations in organizational environments.

What are common challenges faced by a credentials manager, and how can they be addressed?

A Credentials Manager often encounters challenges such as keeping up with frequently changing regulatory requirements, managing large volumes of sensitive data, and ensuring timely renewals for staff credentials. Staying organized with robust tracking systems and maintaining clear communication with team members can help prevent lapses or compliance issues. Additionally, adopting credentialing software and regular training on industry standards can significantly reduce errors and improve efficiency in the role.

What is the difference between Credentials Manager vs Credential Analyst?

AspectCredentials ManagerCredential Analyst
Required credentialsCertifications in security, IT, or compliance; experience in credential management systemsCertifications in data analysis, security, or compliance; knowledge of credential standards
Work environmentCorporate, IT departments, security teamsCompliance departments, security teams, data analysis units
Employer and industry usageUsed in IT, security, and corporate compliance sectorsCommon in security, compliance, and auditing fields
Search and comparison intentUnderstanding roles related to credential management and securityAnalyzing credential data and compliance status

While both roles involve handling credentials, a Credentials Manager primarily oversees the secure storage and management of credentials within organizations, focusing on security and access control. A Credential Analyst, on the other hand, analyzes credential data for compliance, validation, and auditing purposes. Both roles are vital in security and compliance sectors but serve different functions within organizations.

Is credentialing a hard job?

Credentialing is a detailed and organized role that involves verifying qualifications, licenses, and certifications of healthcare providers or professionals. It requires attention to accuracy, knowledge of industry standards, and often involves working with databases and documentation, making it moderately challenging depending on the complexity of the credentialing process. Strong organizational skills and familiarity with credentialing software can help manage the workload effectively.

What are the most commonly searched types of Credentials jobs in Pennsylvania?

The most popular types of Credentials jobs in Pennsylvania are:

What cities in Pennsylvania are hiring for Credentials Manager jobs?

Cities in Pennsylvania with the most Credentials Manager job openings:

Credentials Manager jobs near you

Credentialing Coordinator

WellSpan Health

York, PA • On-site

Full-time

Medical, Retirement, PTO

Re-posted 13 days ago

Key responsibilities

  • Processes initial provider enrollment, recredentialing, and reappointments by preparing application packets, completing primary source verifications, and submitting applications to payers.

  • Maintains communication with providers, practice managers, medical staff, insurance reps, and other stakeholders to ensure timely credentialing and recredentialing.

  • Follows up on enrollment statuses, updates provider information in systems, and creates change letters to notify payers and stakeholders of data changes.

WellSpan Health rating

7.6

Company rating: 7.6 out of 10

Based on 307 frontline employees who took The Breakroom Quiz

191st of 898 rated healthcare providers

Job description

General Summary

Maintains close communication with providers, practice managers and the medical staff office to ensure timely initial credentialing, recredentialing and reappointments through the different entities, Credentials Committee and Board of Directors Meetings.

Qualifications
Minimum Education:

  • High School Diploma or GED Required
  • Associates Degree Preferred

Work Experience:

  • 2 years Relevant experience. Required
  • Hospital/physician office/insurance claims or credentialing experience. Preferred

Licenses:

  • Certified Provider Credentialing Specialist Upon Hire Preferred

Knowledge, Skills, and Abilities:

  • Ability to multi-task and work independently by prioritizing work load.
  • High level of organizational skills.
  • Proficiency in data entry.
  • Ability to handle interruptions such as phone calls, emails and meetings.
  • Excellent computer skills.
  • Excellent communication/interpersonal skills.

Benefits Offered:

  • Comprehensive health benefits
  • Retirement savings plan
  • Paid time off (PTO)
  • Education assistance
  • Financial education and support, including DailyPay
  • Expanded Paid Parental Leave

For additional details:Benefits & Incentives | WellSpan Careers (joinwellspan.org)

Duties and Responsibilities
Essential Functions:

  • Processes initial provider enrollment with payers, initial credentialing and recredentialing: Creates, assembles and prepares application packet for providers to complete, reappointment applications for WellSpan Health entities and submits applications to payers. Completes primary source verifying provider credentials per established policies and procedures. Enters provider credentials and application requirements into Cactus, CAQH. Initiates mandated queries, both federal and state, for all initial applicants and those due for recredentialing with the National Practitioner Data Bank. Adheres to all policies and procedures regarding mandated queries and reporting mechanisms. Maintains close communication with provider, practice managers, medical staff office, insurance reps, locum tenens agencies, office administrators to ensure timely credentialing through the different entities. Reviews and conducts QA checks on the applications prior to medical director's review. Reattests provider information every 120 days in CAQH. Runs reports and complete Medicare and Medicaid revalidations for WellSpan Medical Group (WSMG) & Hospital Based providers. Maintains confidentiality of provider information.
  • Data Management Follows up, receives and documents confirmations on all initial enrollment status and changes for health plan providers with which WellSpan participates. Runs weekly Credentialing Update reports to IS Department for billing system update. Runs expiring provider credentials reports, notifies practices and updates Cactus accordingly. Assists with helping resolve claim issues by contacting applicable provider reps.
  • Change letters Creates and submits letters to update payers, Cactus, CAQH, NPI and other stakeholders of any changes and terms to provider data per 25 payer requirements.

Common Expectations:

  • Maintains established policies and procedures, objectives, quality assessment and safety standards.
  • Maintains professional growth and development.
  • Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

What WellSpan Health employees say

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