Human Resources and Credentialing Manager

Job Overview

Join our dynamic organization as a Human Resources and Credentialing Manager, where you will lead strategic HR initiatives and oversee credentialing processes to ensure compliance, efficiency, and excellence. This pivotal role combines talent management, regulatory adherence, and team leadership to foster a positive workplace environment. You will drive HR operations, develop policies, and support senior leadership in shaping organizational growth. Your energetic approach will inspire teams and promote a culture of continuous improvement and accountability.

Responsibilities

• Develop and implement comprehensive HR strategies aligned with organizational goals, including talent acquisition, performance management, and succession planning.
• Oversee credentialing processes to ensure all team members meet licensing, certification, and regulatory requirements.
• Lead employee onboarding, orientation programs, training & development initiatives, and employee relations management to enhance engagement and retention.
• Ensure compliance with employment & labor law, OSHA regulations, FMLA policies, Workers' Compensation procedures, and HR legal standards.
• Supervise human resources teams across multiple functions including benefits administration, payroll processing, conflict management, and employee misconduct investigations.
• Collaborate with senior leadership on organizational design projects, process improvements, change management strategies, and strategic planning efforts.
• Report to management and provide decision support through HR metrics
• Bridge management and employee relations by addressing demands, grievances or other issues
• Nurture a positive working environment

Credentialing

• Responsible for Compiling and maintaining current and accurate data for all providers.
• Responsible for Data entry and maintaining provider information in online credentialing databases and system (CAQH, CMS/PECOS, and NPPES).
• Responsible for Verification of State license, DEA, and Board certification.
• Responsible for Completing provider initial and re-credentialing applications.
• Audits applications for accuracy and completeness.
• Responsible for revalidation requests issued by government payers.
• Responsible for Submitting completed credentialing application and supporting documentation to all requested payers.
• Responsible for monitoring application progress and following up with payers as needed until confirmation of “in network” status has been received. Responsible for maintaining copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers. As well as tracking all state license, DEA, and board certification expirations for all providers to ensure timely renewals.

Skills

• Strong negotiation skills coupled with talent acquisition expertise to attract top candidates.
• Excellent communication skills for effective presentation of data analysis findings and strategic initiatives.
• Deep understanding of employment law in talent management and HR compliance standards.
• Ability to handle confidential information with integrity while managing complex employee relations issues.
• Skilled in analytics for data collection and process improvement initiatives to optimize HR and credentialing functions.
• Demonstrated leadership in managing human resources and credentialing within fast-paced environments.
• Strategic thinker with expertise in change management, organizational design, succession planning, and program management.
• Adept at managing contracts related to employment terms and benefits administration while ensuring regulatory compliance.
• Familiar with provider credentialing and recredentialing requirement.
• Skilled in efficiency, organization, time management, and prioritization.
• Ability to communicate effectively and relate to people of different cultures and work well with others.

Experience Requirements:

• High School Diploma
• Minimum of 2 years related experience preferred
• Demonstrable experience with Human Resources metrics
• Working knowledge of credentialing accreditation regulations, policies, and procedures
• Healthcare: 1 year (Preferred)
• Expert level knowledge of Microsoft Office Products.
• Experience with credentialing software preferred.
• Able to sit and work at a computer keyboard for extended periods.
• Ability to architect strategy along with leadership skills
• Excellent active listening, negotiation and presentation skills
• Competence to build and effectively manage interpersonal relationships at all levels of the company

Policies and Procedures:

Protects patients’ rights by maintaining confidentiality of personal and financial information. Maintain operations by following policies and procedures; reporting needed changes. Protects patient confidentiality by making sure protected health information (PHI) is secured by not leaving PHI in plain sight and logging off the computer before leaving it unattended. Other duties as assigned.

Physical Requirements and Work Environment:

*The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Prolonged computer usage, occasional lifting of computer equipment, and a need for dexterity to manage cables and hardware, while being exposed to potential noise from servers and other computer components. Must be able to sit or stand for long periods of time, with occasional walking. Ability to bend and lift 30 or more pounds. Hearing and vision required.

This role offers an exciting opportunity to shape our organization's human capital strategy while fostering a vibrant workplace culture. We value energetic professionals who are passionate about developing people-centric solutions that drive organizational success. Join us to make a meaningful impact through innovative HR practices!

Pay: $66,560.00 - $79,040.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person