University HealthCare Alliance (UHA), a medical foundation of Stanford Hospital & Clinics (SHC), has created an exciting opportunity for a full-time Credentialing Manager in Richmond, CA. This role will be responsible for building and overseeing a team to manage all aspects and operations of provider credentialing and roster management for UHA and its partnering entities, including providers participating in UHA’s Foundation Medical Groups, providers contracted with UHA affiliated IPAs and SHC.
The Team will be responsible for maintaining an accurate provider roster and their affiliation with the organization, completing primary source verification for provider applicants, completing initial credentialing and re-credentialing, facilitating and documenting all necessary peer review meetings and serving as the escalation for credentialing related issues and matters.
Requires a Bachelor’s degree, 5+ years of experience performing physician credentialing at a medical group, hospital or health plan, 3+ years of experience in staff supervision, CPMSM or CPCS certification (or demonstrated progress towards achieving certification) and knowledge of California Industry Collaborative Effort (ICE) and NCQA credentialing guidelines. Strong interpersonal, collaboration, written/verbal communication, prioritization, computer, project management and analytical skills are essential. Active membership in the National Association of Medical Staff Services (NAMSS), California Association of Medical Staff Services (CAMSS) or other professional organization related to credentialing verification is preferred.