Manager - Credentialing Operations

Description

Management/Leadership
Req #: 79756

Summary:

The Manager - Credentialing Operations serves as the operational leader for MaineHealth's centralized Credentialing Verification Organization (CVO), overseeing a remote team responsible for provider credentialing across a large integrated health system and several external clients. This position is responsible for ensuring operational excellence, regulatory compliance, workforce performance, customer service, and continuous process improvement across credentialing operations.

The successful candidate will be a strong people leader who can effectively manage a remote workforce, establish accountability, develop staff, improve workflows, leverage technology, and drive measurable operational outcomes. This role requires someone who is equally comfortable leading teams, resolving operational challenges, analyzing performance data, and partnering with stakeholders across Medical Staff Services, Provider Enrollment, Compliance, Legal, Human Resources, physician leadership, and external clients.

This is a highly visible leadership role that will play a key part in the continued maturation of MaineHealth's centralized credentialing model, including workflow optimization, technology enhancements, operational standardization, external client support, and development of performance metrics that improve provider onboarding and credentialing outcomes.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

1. Education: Bachelor's degree in health administration, business or related field preferred.
2. License/Certifications: Certified Provider Credentialing Specialist (CPCS) from the National Association of Medical Staff Services required within one year of start date.
3. Experience: Minimum of 5 years of progressive experience in credentialing or medical staff services; At least 2 years of leadership or supervisory experience, preferably within a centralized or enterprise credentialing model; Experience managing credentialing for both internal operations and external contracted entities is strongly preferred.
4. Additional Skills/Requirements Required: Experience with credentialing software platforms (e.g., CredentialStream, MD-Staff, Cactus) and regulatory standards (TJC, NCQA, CMS) required. Strong knowledge of credentialing regulations, verification practices, and accreditation requirements. Excellent interpersonal and leadership skills, with a focus on coaching, performance improvement, and team development. Strong organizational and analytical skills, including ability to interpret data and drive improvements. Comfortable managing competing priorities and working in a high-volume, fast-paced environment. Skilled in fostering collaboration across departments and external stakeholders.
5. Additional Skills/Requirements Preferred: Prior experience working with external partners or contracted credentialing services is a plus.

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Additional Information

If you have questions about this role, please contact lauren.robare@mainehealth.org