Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve.

Job Description:

The Credentialing Manager will report to OneOncology’s Sr. Manager, Credentialing and is responsible for leading the day-to-day activity and workflow of assigned practices and their credentialing team members. The Manager is responsible for the performance of their Credentialing Team with oversight of credentialing, re-credentialing, and privileging processes for health care providers while complying with state and federal standards. Additional responsibilities include maintaining up-to-date data in credentialing databases, electronic systems and hard copy files as well as tracking and managing provider licenses, certifications, and other related documentation.

Responsibilities

• Lead a team of Credentialing Specialists to ensure timely and accurate processing of hospital applications and payer enrollments for multiple practice locations, proactively resolving delays or issues

• Support the Credentialing Team by directly performing enrollment, credentialing, and license application/renewal functions when needed

• Prioritize and ensure timely provider onboarding with routine communication regarding progress, delays, and needs

• Serve as a leader by supporting administrative tasks such as interviewing candidates, leading education sessions, and offering support to the Credentialing Supervisors and Specialists

• As necessary, conduct practice level assessments, document current work process, and develop a gap analysis to OO’s standard practices

• Assist credentialing leadership with the design and management of policies and procedures related to the credentialing and enrollment processes, ensuring compliance with all regulatory and accreditation requirements

• Support process improvement initiatives streamlining credentialing activities for assigned practices

• Assist in the workflow design and implementation of new technology features released by our technology vendors

• Serve as a subject matter expert and resource across the OneOncology platform for partner practices and internal departments

• Work with leadership to develop standard reporting packages

• Build and maintain relationships with external partners and payers and communicate with payers on questions or barriers in information

• Coordinate with the Revenue Cycle Management team to triage questions related to licensing, credentialing and enrollment, assist in the resolution of claims denied due to credentialing and enrollment issues, and payor portal management

• Other tasks as assigned to drive our mission of improving the lives of everyone living with cancer

Key Competencies

• Current or recent hands-on experience in leading credentialing and enrollment activities

• Experience working with NCQA criteria

• Excellent written and verbal communication skills

• Participate in the implementation of credentialing software tools

• Strong organizational capabilities and the ability to manage multiple complex projects at the same time

• Data aggregation and analysis

Qualifications

• 5+ years credentialing/non-delegated enrollment experience required

• 3+ years Supervisory experience required, preferably in a credentialing/enrollment environment

• Current working knowledge/expertise of enrollment processes with Commercial and Government payors is required

• Experience leading credentialing and enrollment activities in large provider practice (or multiple practices) is highly preferred

• Bachelor’s degree preferred

• Training experience preferred but not required

• Certifications preferred but not required

• Remote work capability with flexibility for travel as needed

#LI-REMOTE