Optalis Healthcare
Corporate Provider & Vendor Credentialing Specialist
Optalis Healthcare, Novi, Michigan, United States, 48377
Corporate Provider & Vendor Credentialing Specialist
Location:
Corporate Office - Optalis Health & Rehabilitation (Hybrid) Reports To:
Corporate Director of Human Resources FLSA Status:
Salary Exempt
Position Summary:
The Corporate Credentialing Manager is responsible for overseeing and managing all credentialing and recredentialing activities for physicians, allied health professionals, and third-party vendors serving the organization's skilled nursing and assisted living facilities. This critical role ensures compliance with state, federal, payer, and organizational requirements while maintaining the highest standards of accuracy and timeliness. The role requires exceptional attention to detail, organizational skills, and the ability to collaborate with internal departments, providers, vendors, and regulatory agencies. The Corporate Credentialing Manager plays a vital part in protecting the organization from compliance risks, ensuring uninterrupted patient care services, and supporting facility operations through the timely onboarding of qualified providers and vendors.
Key Responsibilities: Lead and manage the credentialing and re-credentialing process for physicians, nurse practitioners, therapists, agency staff, and third-party vendors across all facilities. Verify provider and vendor credentials, licenses, certifications, malpractice coverage, background checks, and other required documentation. Maintain up-to-date records within the credentialing database and ensure documentation is stored securely and in compliance with regulations. Partner with facility leadership, HR, Payroll, and Compliance to ensure all providers and vendors are fully credentialed before providing services. Monitor credentialing expiration dates and proactively initiate renewals to avoid service interruptions. Audit credentialing files across all facilities for accuracy, completeness, and regulatory compliance. Develop and implement standardized credentialing policies and workflows across the organization. Collaborate with regulatory bodies, insurers, and accrediting agencies to resolve credentialing questions or discrepancies. Support acquisitions and new entity onboarding by building and integrating credentialing files and processes. Generate reports and provide regular updates to executive leadership on credentialing status, upcoming expirations, and areas of risk. Serve as subject matter expert (SME) for credentialing compliance in SNF/long-term care operations. Skills & Competencies
Strong organizational and multitasking skills with meticulous attention to detail. Knowledge of federal/state healthcare regulations, payer credentialing requirements, and SNF Compliance standards.
Excellent communication and relationship-building skills with providers, vendors, and leadership. Proficiency with credentialing databases, Microsoft Office Suite, and document management systems. Analytical skills to audit files, identify gaps, and recommend corrective actions. Ability to maintain confidentiality of sensitive provider and vendor information. Qualifications Required:
Minimum 3-5 years' experience in healthcare credentialing, HR compliance, or provider enrollment. Previous HR or Payroll department experience with exposure to compliance, onboarding, or personnel files. Familiarity with regulatory requirements for credentialing in long-term care or healthcare. Demonstrated ability to manage multiple priorities in a fast-paced, multi-facility environment. Preferred:
Experience with skilled nursing or post-acute care credentialing. Certification in credentialing (e.g., CPCS, CPMSM) or willingness to obtain. Experience supporting acquisitions or multi-state credentialing operations. Physical & Work Requirements
Ability to sit and work at a computer for extended periods with frequent data entry. Manual dexterity for document management and electronic file updates. Occasional travel required for audits, acquisitions, and facility support. Clear verbal and written communication to support providers, vendors, and leadership teams. Personal Attributes:
Strong Negotiation Skills Ability to Influence Others Effective Time Management Adaptability & Change Management Excellent Planning & Organizational Skills High Integrity & Ethical Standards Analytical Thinking Results-Oriented Mindset
#corp
Corporate Office - Optalis Health & Rehabilitation (Hybrid) Reports To:
Corporate Director of Human Resources FLSA Status:
Salary Exempt
Position Summary:
The Corporate Credentialing Manager is responsible for overseeing and managing all credentialing and recredentialing activities for physicians, allied health professionals, and third-party vendors serving the organization's skilled nursing and assisted living facilities. This critical role ensures compliance with state, federal, payer, and organizational requirements while maintaining the highest standards of accuracy and timeliness. The role requires exceptional attention to detail, organizational skills, and the ability to collaborate with internal departments, providers, vendors, and regulatory agencies. The Corporate Credentialing Manager plays a vital part in protecting the organization from compliance risks, ensuring uninterrupted patient care services, and supporting facility operations through the timely onboarding of qualified providers and vendors.
Key Responsibilities: Lead and manage the credentialing and re-credentialing process for physicians, nurse practitioners, therapists, agency staff, and third-party vendors across all facilities. Verify provider and vendor credentials, licenses, certifications, malpractice coverage, background checks, and other required documentation. Maintain up-to-date records within the credentialing database and ensure documentation is stored securely and in compliance with regulations. Partner with facility leadership, HR, Payroll, and Compliance to ensure all providers and vendors are fully credentialed before providing services. Monitor credentialing expiration dates and proactively initiate renewals to avoid service interruptions. Audit credentialing files across all facilities for accuracy, completeness, and regulatory compliance. Develop and implement standardized credentialing policies and workflows across the organization. Collaborate with regulatory bodies, insurers, and accrediting agencies to resolve credentialing questions or discrepancies. Support acquisitions and new entity onboarding by building and integrating credentialing files and processes. Generate reports and provide regular updates to executive leadership on credentialing status, upcoming expirations, and areas of risk. Serve as subject matter expert (SME) for credentialing compliance in SNF/long-term care operations. Skills & Competencies
Strong organizational and multitasking skills with meticulous attention to detail. Knowledge of federal/state healthcare regulations, payer credentialing requirements, and SNF Compliance standards.
Excellent communication and relationship-building skills with providers, vendors, and leadership. Proficiency with credentialing databases, Microsoft Office Suite, and document management systems. Analytical skills to audit files, identify gaps, and recommend corrective actions. Ability to maintain confidentiality of sensitive provider and vendor information. Qualifications Required:
Minimum 3-5 years' experience in healthcare credentialing, HR compliance, or provider enrollment. Previous HR or Payroll department experience with exposure to compliance, onboarding, or personnel files. Familiarity with regulatory requirements for credentialing in long-term care or healthcare. Demonstrated ability to manage multiple priorities in a fast-paced, multi-facility environment. Preferred:
Experience with skilled nursing or post-acute care credentialing. Certification in credentialing (e.g., CPCS, CPMSM) or willingness to obtain. Experience supporting acquisitions or multi-state credentialing operations. Physical & Work Requirements
Ability to sit and work at a computer for extended periods with frequent data entry. Manual dexterity for document management and electronic file updates. Occasional travel required for audits, acquisitions, and facility support. Clear verbal and written communication to support providers, vendors, and leadership teams. Personal Attributes:
Strong Negotiation Skills Ability to Influence Others Effective Time Management Adaptability & Change Management Excellent Planning & Organizational Skills High Integrity & Ethical Standards Analytical Thinking Results-Oriented Mindset
#corp