Job Description: RediClinic,
a known leader in the retail health industry, is experiencing rapid growth and is in need of a Credentialing Manager to join our corporate team in Houston, Texas!
RediClinic is a subsidiary of Rite Aid Corporation, a Fortune 500 Company. RediClnic has 100 clinic locations in Texas, New Jersey, Pennsylvania, Delaware, Maryland, Washington and Virginia!
Our corporate office is located in the beautiful Greenway Plaza area near the Galleria in Central Houston.
The Credentialing Manager is responsible for all aspects of the credentialing, recredentialing, and privileging processes for all medical providers who provide patient care at RediClinic.
Essential Duties and Responsibilities include:
- Compiles and maintains current and accurate data for all providers.
- Completes provider credentialing and recredentailing applications; monitors applications and follow-up as needed. Familiar with NCQA standards.
- Maintains copies of current state licenses, necessary certificates, malpractice coverage and any other required credentialing documents for all providers.
- Prepares and leads the Credentialing Committee.
- Maintains knowledge of current health plan and agency requirements for credentialing providers.
- Tracks license and certification expirations for all providers to ensure timely renewals.
- Ensures practice addresses are current with health plans, agencies, and other entities.
- Processes applications for appointment and reappointment of privileges to RediClinic.
- Tracks license and professional liability expirations for appointed RediClinic providers.
- Maintains RediClinic appointment files and information on credentialing database.
Prepares and submits paperwork required for managed care provider enrollment and updates EMR accordingly.
This position directly suprervises and carries out supervisory responsibilities in accordance with Rite Aid policies and applicable laws. Responsibilities include interviewing, hiring, training, directing, rewarding, and disciplining associates; appraising associate performance; and resolving complaints. APPLY NOW!
Experience / Requirements:
- Two (2) years' of experience in Relevant credentialing experience required.
- Or equivalent combination of education and experience.
- High School Diploma or General Education Degree (GED) required.
- Associate's Degree (AA) preferred.
- Other, Certified Provider Credentialing Specialist preferred.
A little about us:
We create caring moments by delivering what matters most to our customers.