Healthcare Credentialing Manager

Alma Media is a media and service company focusing on digital services and publishing. In addition to news services, our products provide useful information related to lifestyle, career and business development. Alma Media employs approximately 2,300 people (excluding delivery personnel), over one third of whom work outside Finland in nine different European countries. Our revenue in 2016 totalled approximately EUR 353 million. Read more at www.almamedia.com.

Alma is on a mission to simplify access to high-quality, affordable mental health care by supporting therapists and providing a comprehensive network. The Credentialing Manager will be responsible for ensuring audit readiness, maintaining NCQA standards, managing payer audits, and leading initiatives to improve credentialing and revenue cycle management efficiency. Key responsibilities include managing delegation audits, implementing NCQA standards, designing compliance scorecards, monitoring policies, and leading process improvements. The role also involves overseeing partner performance, conducting staff training, supporting credentialing committees, and executing operational tasks. The ideal candidate has over 6 years of healthcare credentialing experience, expertise in delegated credentialing, NCQA standards, and knowledge of behavioral health regulations. Preferred qualifications include professional certifications (CPCS or CHPC), experience in mental/behavioral health, and startup environment experience.

Alma is seeking a Credentialing Manager to oversee healthcare credentialing, compliance, and process improvement efforts.

Credentialing Manager

United States

Alma is on a mission to simplify access to high-quality, affordable mental health care by supporting therapists and providing a comprehensive network. The Credentialing Manager will be responsible for ensuring audit readiness, maintaining NCQA standards, managing payer audits, and leading initiatives to improve credentialing and revenue cycle management efficiency. Key responsibilities include managing delegation audits, implementing NCQA standards, designing compliance scorecards, monitoring policies, and leading process improvements. The role also involves overseeing partner performance, conducting staff training, supporting credentialing committees, and executing operational tasks. The ideal candidate has over 6 years of healthcare credentialing experience, expertise in delegated credentialing, NCQA standards, and knowledge of behavioral health regulations. Preferred qualifications include professional certifications (CPCS or CHPC), experience in mental/behavioral health, and startup environment experience.Requirements:<ul><li> Proven ability to interpret complex regulatory language (NCQA, CMS, etc.) and translate it into operational workflows</li><li> 6+ years of progressive experience in healthcare credentialing, with a focus on managing delegated functions</li><li> Deep understanding of NCQA standards and their application</li><li> Strong working knowledge of revenue cycle management and behavioral health regulations</li><li> Experience establishing, monitoring, and reporting compliance KPIs and scorecards</li><li> Exceptional organizational and project management skills</li></ul>Benefits:<ul><li> We’re a remote-first company</li><li> Health insurance plans through Aetna (medical and dental) and MetLife (vision), including FSA and HSA plans</li><li> 401K plan (ADP)</li><li> Monthly therapy and wellness stipends</li><li> Monthly co-working space membership stipend</li><li> Monthly work-from-home stipend</li><li> Financial wellness benefits through Northstar</li><li> Pet discount program through United Pet Care</li><li> Financial perks and rewards through BenefitHub</li><li> EAP access through Aetna</li><li> One-time home office stipend to set up your home office</li><li> Comprehensive parental leave plans</li><li> 12 paid holidays and 1 Alma Give Back Day</li><li> Flexible PTO</li></ul>

Alma Media Oyj

Credentialing Manager Alma is seeking a Credentialing Manager to oversee healthcare credentialing, compliance, and process improvement efforts. Alma is on a mission to simplify access to high-quality, affordable mental health care by supporting therapists and providing a comprehensive network. The Credentialing Manager will be responsible for ensuring audit readiness, maintaining NCQA standards, managing payer audits, and leading initiatives to improve credentialing and revenue cycle management efficiency. Key responsibilities include managing delegation audits, implementing NCQA standards, designing compliance scorecards, monitoring policies, and leading process improvements. The role also involves overseeing partner performance, conducting staff training, supporting credentialing committees, and executing operational tasks. The ideal candidate has over 6 years of healthcare credentialing experience, expertise in delegated credentialing, NCQA standards, and knowledge of behavioral health regulations. Preferred qualifications include professional certifications (CPCS or CHPC), experience in mental/behavioral health, and startup environment experience. Healthcare Credentialing Manager Director Alma Media Oyj media-production advertising-services ats career-fairs cv-database employer-branding human-resources international-recruiting internet-services it-consulting it-services media newspapers online-media print-media programmatic recruiting sourcing virtual-career-fairs publishing advertising

The Credentialing Manager will lead audit readiness, ensure regulatory compliance, and improve revenue cycle management processes. This role requires extensive healthcare credentialing experience, NCQA knowledge, and leadership in a remote healthcare environment.

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