Sr. Manager, Credentialing
Strive Health
This job is no longer accepting applications
See open jobs at Strive Health.See open jobs similar to "Sr. Manager, Credentialing" Redpoint Ventures.What We Strive For
Strive Health is built for purpose — to transform a broken kidney care system. We are fundamentally changing the lives of people with kidney disease through early identification, engagement and comprehensive coordinated care. Strive’s model is driven by a high-touch care team that integrates with local providers and spans the entire care journey from chronic kidney disease through end-stage kidney disease, leveraging comparative and predictive data and analytics to identify at-risk patients. Strive Health’s interventions significantly reduce the rate of emergent dialysis crash, cut inpatient utilization and significantly improve patient outcomes and experience. Come join our journey as we create THE destination for top talent in the healthcare community and set a new standard for how kidney care should be done.
Why We’re Worth the Application
- We Strive for excellence and Strive has been recognized with six Best Place to Work awards, including Forbes America’s Best Startup Employers 2023 and 2022, Built In Colorado’s Best Places to Work 2022 and 2024, Comparably’s Best Places to Work in Denver 2022 and The Tech Tribune’s Best Startups in Denver 2022. Additionally, Strive’s CEO, Chris Riopelle, has been recognized as one of Denver Business Journal’s Most Admired CEOs.
- We derive innovation and ideas from through authentic diversity intentionally building a team that represents the populations we serve in partnership with our Employee Resource Groups:
- Strive Forward - LGBTQ
- Underrepresented Minorities
- Women and Allies
- Parent and Caregivers
- We care and support our Strivers within and beyond work to feel fully charged and empowered through our generous wellbeing offerings including:
- Flexible time off
- Sick time off
- Companywide wellbeing days
- Two comprehensive EAPs and a variety of mental health tools
- Volunteer time off
- Leave packages including a sabbatical, parental leave and eight weeks paid for living donor
- Professional development
- Financial wellness resources
- Carrot Fertility and Peloton for all Strivers
- We like to have fun by celebrating our successes as a team through team building, company gatherings, experiential incentives, core value awards, a companywide book club and more.
- We value tenacity to help us overcome obstacles with grit and determination to deliver compassionate kidney care.
Sr. Manager, Credentialing
Strive Health is looking for a Credentialing Senior Manager to develop, improve, and monitor the credentialing, licensing, and enrollment processes for Strive Health providers. This role oversees the internal credentialing team as well as external vendors and processes. This position ensures compliance with the appropriate accrediting and regulatory agencies and manages the Delegated Credentialing process, including Credentialing Committee.
Essential Functions
- Oversees the day-to-day operations of the Credentialing team
- Owns the credentialing policies and processes for all Strive Health clinical providers in accordance with all state and federal laws.
- Manages the credentialing database and associated modules, ensuring accuracy of data and reporting to downstream systems. Monitors critical data for extensive analysis and report generation.
- Oversight of the expirable process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
- Ensures compliance with our Delegated Credentialing agreements
- Manages our external licensing and enrollment vendor
- Monitors and reports turnaround times for processing of applications, with continued focus on delivery of a high-quality product, with the greatest efficiency, in the least amount of time,
- Provides Leadership with credentialing updates as it relates to credentialing practices and services; prepares and conducts credentialing orientations and provides updates as appropriate on new policies and procedures.
- Identifies process improvement opportunities
- Prepares for and coordinates credentialing audits in compliance with the managed care delegated credentialing contract
- Oversees the supervision of personnel, which includes hiring qualified candidates to expand the team, work allocation, training, promotion, enforcement of internal procedures and controls, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
- Represents the credentialing function to internal and external customers as appropriate; makes presentations to and interacts with various internal and external customers on issues pertinent to area of specialty.
Minimum Qualifications
- Bachelor’s degree in business or related field and/or equivalent work experience
- 5+ years’ experience credentialing experience preferred for a health plan and or large healthcare entity such as a hospital
- 5+ years’ experience in a medical practice business office role required
Preferred Qualifications
- Knowledge of provider credentialing and its direct impact on the practice’s revenue cycle
- Excellent computer skills including Excel, Word, and Internet use
- Detail oriented with above average organizational skills
- Plans and prioritizes to meet deadlines
- Excellent customer service skills; communicates clearly and effectively
- Experience with various clinical provider credentialing processes, as well as healthcare entity credentialing with major payers such as Medicare.
- Familiar with credentialing platforms and CAQH requirements
- Working knowledge of NCQA Credentialing accreditation requirements and processes
Annual Base Salary Range:: $109,000.00 - $136,000.00
Strive Health offers competitive compensation and benefits, including Health insurance, Dental insurance, Vision insurance, 401k Retirement Plan with Employer Match, Life and Accidental Death & Dismemberment insurance, Disability insurance, Health Savings Account, Flexible Spending Account, paid company holidays, in addition to Vacation Time Off. An annual performance bonus, determined by company and individual performance, is available for many roles as aligned to Strive Health guidelines.
Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet all qualifications. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talentacquisition@strivehealth.com
This job is no longer accepting applications
See open jobs at Strive Health.See open jobs similar to "Sr. Manager, Credentialing" Redpoint Ventures.