Credentialing Manager

The Rural Health Enterprise is seeking an experienced Credentialing Manager to oversee our Delegated Credentialing Program. This role ensures compliant provider enrollment and recredentialing, and serves as a key liaison with hospitals and delegated health plans.

About us

The Rural Health Enterprise (RHE), a dynamic for-profit subsidiary of The Rural Collaborative, owned collectively by 23 rural hospitals across Washington State, is dedicated to enhancing the sustainability and quality of rural healthcare. RHE provides crucial support through interdependence and value-based services.

Key Responsibilities

· Manage and supervise credentialing staff

· Ensure timely provider enrollment and recredentialing

· Maintain credentialing databases and monthly rosters

· Ensure compliance with NCQA and health plan requirements

· Oversee credentialing and CVO files and conduct quality audits

· Prepare for health plan audits and corrective action plans

· Collaborate with leadership, hospitals, and health plans

Qualifications

· Bachelor’s degree or equivalent experience preferred

· 4+ years healthcare experience

· 3+ years credentialing experience (health plan, provider organization, or hospital)

· Strong knowledge of NCQA standards

· CPCS or CPMSM certification preferred

· Proficiency in Microsoft Office (Excel required)

Work Environment

· Remote, home-office based

· Must reside in Washington State

· Occasional in-state travel required

· Background check required

Why Join RHE?  We offer a dynamic work environment where you can make a significant impact on rural healthcare delivery in Washington State. As part of our team, you will have the opportunity to contribute to meaningful projects and initiatives that support our mission of enhancing rural hospital sustainability through collaborative, value-based services.

RHE offers competitive pay and benefits including M/D/V, HSA contribution, retirement match of 6%, and generous PTO.

Join us at RHE and be part of a team that is dedicated to making a difference in rural healthcare!