Position Description:   The Credentialing Manager will be responsible for ensuring compliance with regulatory requirements, maintaining accurate credentialing records, and facilitating the timely credentialing of healthcare professionals. This role requires strong communication skills, attention to detail, and knowledge of credentialing standards and processes in healthcare settings.

Our Company Promise

We are committed to providing our Employees a stable work environment with equal opportunity for learning and personal growth. Vighter’s Mission is to provide efficient, fast, high quality healthcare staffing to our clients.

Our Culture’s key elements are crucial to the effectiveness of our employees in accomplishing our mission. The key elements include:

Dependability Integrity Personability Transparency Responsiveness

Creating and cultivating this Culture within the organization is our commitment to our employees.  Above all, Vighter employees will be provided the same concern, respect, and caring attitude that they are expected to share externally with every Vighter Client and Customer.

Title:  Credentialing Manager

 

Location: San Antonio, Texas

 

Reports to: National Human Resources Manager

Job summary:

Vighter LLC is seeking a highly organized and detail-oriented Credentialing Manager to oversee the credentialing and privileging process for healthcare providers within our organization. The Credentialing Manager will be responsible for ensuring compliance with regulatory requirements, maintaining accurate credentialing records, and facilitating the timely credentialing of healthcare professionals. This role requires strong communication skills, attention to detail, and knowledge of credentialing standards and processes.

Principle Accountabilities:

Credentialing Process Management: Oversee the credentialing and privileging process for physicians, advanced practice providers, allied health professionals, and other healthcare staff. Develop and maintain credentialing policies, procedures, and workflows to ensure consistency, efficiency, and compliance with accreditation standards. Coordinate with internal departments, external agencies, and credentialing organizations to obtain verification of provider credentials, licenses, certifications, and other required documents. Quality Assurance and Compliance: Conduct regular audits and reviews of credentialing files and databases to ensure accuracy, completeness, and compliance with regulatory requirements. Monitor changes in credentialing standards, regulations, and payer requirements, and update credentialing processes accordingly. Prepare and submit reports on credentialing activities, performance metrics, and compliance status to management and regulatory agencies as required. Communication and Collaboration: Serve as the primary point of contact for credentialing-related inquiries, issues, and requests from internal stakeholders, healthcare providers, and external organizations. Collaborate with medical staff leaders, department managers, and human resources to address credentialing-related concerns, resolve disputes, and facilitate credentialing decisions. Build and maintain positive relationships with credentialing agencies, licensing boards, and other external partners to streamline the credentialing process and expedite provider approvals. Participate in interdisciplinary meetings and committees to coordinate scheduling efforts, resolve conflicts, and improve interdisciplinary communication and collaboration.

Requirements:

Bachelor's degree in Healthcare Administration, Business Administration, or a related field. Minimum of 5 years of experience in healthcare credentialing, privileging, or provider enrollment, with demonstrated proficiency in credentialing standards and processes. Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) credential preferred. Strong understanding of regulatory requirements, accreditation standards, and payer guidelines related to provider credentialing and enrollment. Excellent organizational skills, with the ability to manage multiple priorities, meet deadlines, and maintain accurate records. Effective communication and interpersonal skills, with the ability to collaborate with diverse groups and convey complex information clearly and concisely.

 

Physical Requirements:

 

Must be able to sit for more than 8 hours per day. Must be willing to work overtime if necessary. Must be able to use an elevator or walk up and down stairs. Must be able to lift up to 10 lbs. and carry up to 10 ft. Must be able to routinely grasp or handle objects, use finger dexterity, bend elbows/knees and reach above and below shoulders. Must be able to read and interpret handwritten and typewritten print. Must be able to communicate by voice and detect sound by ear. Must be able to perform duties in an indoor or outdoor environment. Must be able to pass a criminal background investigation. Must undergo urine drug testing.

 

Vighter LLC is an equal opportunity and affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.