About

InnovaCare Texas Management Services Company, LLC Job Summary Credentialing managers are responsible for managing the process of credentialing individuals in their organization. This includes applications are properly verified and accurately uploaded into internal systems for reference; and uploaded into an online credentialing database system. Essential Job Functions Serve as the primary contact for all credentialing and recredentialing matters by market. Maintain up-to-date knowledge of state and federal regulations, as well as accreditation standards. Coordinates and monitors the timely implementation and maintenance of accurate and up to date credential files for members of our clinical staff. Manages the day-to-day exchange of documents and communications concerning the records and verification required for medical staff applications. Audits files of providers records and evaluates for issues requiring further investigation. Critical thinking, ability to follow through and function independently, has initiative, and has attention to detail, and has excellent organizational skills. Contribute to continuous process improvement activities of the team and partnering teams such as Revenue Cycle Management and Payor Operations Coaches and guides team members as needed. Trains / Onboards new credentialing specialist resources. Draft and distribute monthly and quarterly reports to RCM Officer, Credentialing Leadership, Clinical Operations Leaders, and other senior executives. Other duties as assigned. Required Skills and Qualifications Bachelor’s degree in business, health care administration, human resources, or related field 5+ years’ experience in credentialing, provider relations, or similar role Proficient in Microsoft Office, with aptitude to learn new software and systems. Solid understanding of accreditation standards (NCQA, URAC, etc.) Excellent interpersonal skills Strong project management and organizational skills Ability to multitask and manage competing priorities. Preferred Skills and Qualifications Master’s degree in business, human resources, or related field 7+ years’ experience in credentialing, provider relations, or similar role Experience with CAQH ProView, NAMSS PASSport, or similar credentialing database Working knowledge of medical terminology Familiarity with state and federal regulations governing healthcare providers (Medicare, Medicaid, HIPAA, etc.) The foundation for InnovaCare was laid in 1998 when President and CEO Richard Shinto, M.D., founded North American Medical Management (NAMM) in California. Since then, InnovaCare Health has continuously evolved and innovated to remain at the forefront of healthcare and deliver cutting-edge solutions to our physicians and team members, patients, and their families. Across InnovaCare, we are united by a shared mission, vision, and values. Our growing company strives to make every member of our diverse team feel fulfilled and valued through their work. Our mission is to transform the lives of the people we serve through compassionate, high-quality care, innovative solutions, and trusted partnerships as we vision a new definition of the standard of excellence in healthcare. Today, InnovaCare operates more than 30 clinics and is recognized as a leader in transforming care delivery. Our approach combines physician-led care models with cutting-edge technology and a focus on personalized, coordinated care to empower providers to succeed in some of healthcare's most challenging environments.