Credentialing Manager

Benefits:  40 hours per week, fully remote/work-from-home, 40 hours Paid Time Off annually, 2 Days Weekly Off

Nao Medical is a tech-enabled multi-specialty practice operating across multiple locations in New York. With a focus on delivering quality and comprehensive patient care, we offer a range of services including in-person visits, virtual appointments, and home visits. Our core values of respect, clarity, and thoughtfulness form the foundation of our patient-centered approach.

Job Summary

Join our team as the Credentialing Manager at Nao Medical who is responsible for overseeing the credentialing process for healthcare providers, including Family Nurse Practitioners (FNPs), Physician Assistants (PAs), and Physicians. This role involves ensuring that all healthcare professionals meet the necessary qualifications and comply with regulatory standards, ultimately contributing to the delivery of high-quality patient care

Credentialing Process Oversight:

Manage and oversee the end-to-end credentialing process for FNPs, PAs, and Physicians, ensuring compliance with accreditation and regulatory requirements.

Develop and implement efficient workflows to streamline the credentialing process while maintaining accuracy and thoroughness.

Verify the qualifications, education, training, and licensure of healthcare providers to ensure alignment with Nao Medical's standards and industry regulations.

Regularly update and maintain a comprehensive database of provider credentials.

Collaboration with Licensing Bodies:

Establish and maintain effective communication channels with licensing boards, regulatory agencies, and other relevant entities to stay informed about changes in licensing requirements.

Ensure that provider licenses and certifications are up-to-date and in compliance with state and federal regulations.

Internal Coordination:

Collaborate with internal departments, including HR, Legal, and Clinical Operations, to gather and verify information required for credentialing.

Facilitate communication between various stakeholders to ensure a smooth and efficient credentialing process.

Policy Adherence and Process Improvement:

Develop and enforce credentialing policies and procedures to maintain consistency and compliance.

Regularly review and assess the credentialing process, identifying areas for improvement and implementing enhancements to optimize efficiency.

Risk Management and Compliance:

Conduct regular audits to ensure that providers meet the organization's credentialing standards and compliance requirements.

Address and mitigate risks related to credentialing issues, and implement corrective actions when necessary to maintain compliance.

G. Provider Relationship Management:

Establish positive and collaborative relationships with healthcare providers, addressing any concerns related to the credentialing process and ensuring a positive experience.

Serve as a point of contact for providers regarding credentialing inquiries and updates.

Skills and Qualifications

Minimum: Bachelor's Degree in Healthcare Administration, Business Administration, or a Related Field

Minimum of 3-5 years of hands-on experience in healthcare credentialing roles in the state of New York

Experience in CAQH, Medicare/Medicaid HMO, and managing Medicare/Medicaid insurance.

Prior experience credentialing different types of healthcare providers, including Family Nurse Practitioners (FNPs), Physician Assistants (PAs), and Physicians in the state of New York or other states.

Optional: Master's Degree in Healthcare Administration, Business, or related field.

A plus: Certification in Healthcare Credentialing: Possession of relevant certifications, such as Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM).

Credentialing Process Expertise: In-depth knowledge of the credentialing process, encompassing provider qualification verification, licensure requirements, and compliance with industry regulations.

Attention to Detail: Exceptional attention to detail for ensuring accuracy in reviewing and verifying the credentials of healthcare providers, avoiding oversights that may impact compliance.

Communication and Interpersonal Skills: Strong communication skills for collaborating with internal departments, licensing boards, and healthcare providers; and to effectively communicate credentialing requirements and updates is essential.

Organizational and Time Management Skills: Effective organizational skills to manage the credentialing process for multiple providers simultaneously, meeting deadlines, and maintaining an efficient workflow.

Analytical and Problem-Solving Skills: Analytical skills for assessing provider qualifications and identifying any discrepancies or issues; addressing challenges and implementing improvements in the credentialing process.

At Nao Medical, we take pride in our innovative solutions. By leveraging technology, we strive to ensure that each patient receives personalized attention and achieves the best possible outcomes.

Nao Medical is an equal-opportunity employer, celebrates diversity, and is committed to building an inclusive environment for all employees and patients.

Send in your application “NAO” and join us in our mission to revive a human-centered approach to healthcare.