Credentialing Manager

6 hours ago

Taguig, National Capital Region, Philippines ZKTeco Solutions Full time ₱120,000 - ₱140,000 per year

Job Description:

The Credentialing Manager is responsible for overseeing and managing the credentialing and privileging process for healthcare providers, ensuring compliance with organizational policies, regulatory requirements, and payer standards. This role involves leading a team that verifies licenses, certifications, work history, and other professional qualifications, while maintaining accurate records and facilitating timely provider onboarding. The Credentialing Manager collaborates with internal stakeholders, external payers, and regulatory bodies to ensure providers are properly credentialed and privileged to deliver care.

Key Responsibilities:

  • Lead and manage the credentialing team, ensuring accurate and timely processing of provider credentials
  • Oversee primary source verification of licenses, certifications, education, work history, and malpractice coverage
  • Ensure compliance with regulatory requirements, accreditation standards, and payer contracts
  • Maintain and audit credentialing files and databases for accuracy and completeness
  • Develop and implement policies, procedures, and workflows to optimize credentialing operations
  • Collaborate with HR, operations, and clinical leadership to facilitate provider onboarding and privileging
  • Prepare reports, dashboards, and metrics for leadership regarding credentialing status, timelines, and compliance
  • Address and resolve issues related to credentialing discrepancies or delays

Qualifications:

  • Bachelor's degree in Healthcare Administration, Nursing, or related field
  • Minimum of 3–5 years of experience in provider credentialing and privileging
  • Proven leadership experience managing a credentialing or provider services team
  • Strong knowledge of state and federal regulations, accreditation standards, and payer credentialing requirements
  • Experience with credentialing software and databases

Skills & Tools:

  • Excellent organizational, analytical, and problem-solving skills
  • Strong communication and interpersonal skills for interacting with providers, payers, and internal teams
  • Attention to detail and ability to manage multiple priorities and deadlines
  • Proficiency in Microsoft Office (Excel, Word, PowerPoint) and credentialing systems

Preferred Experience:

  • Familiarity with The Joint Commission, NCQA, URAC, or other accreditation standards
  • Experience in a hospital, health system, or multi-specialty clinic environment

Job Types: Full-time, Permanent

Pay: Php120, Php140,000.00 per month

Benefits:

  • Health insurance
  • Opportunities for promotion
  • Paid training
  • Promotion to permanent employee

Experience:

  • provider credentialing and privileging: 4 years (Preferred)

Work Location: In person

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