Credentialing Manager

CLS Health PLLC•Webster, TX

4d•Onsite

About The Position

At CLS Health, we are redefining healthcare delivery. As Houston’s largest physician-owned, physician-led healthcare system, our mission is to provide patient-centered care through innovation and operational excellence. With over 200 providers in 35+ locations and over 50 specialties, we’re building a scalable healthcare system that empowers physicians and delivers unmatched quality and access for patients. We are Looking for: CLS Health is seeking a detail-oriented and experienced Credentialing Manager to oversee the daily operations of the credentialing team. The Credentialing Manager is responsible for ensuring all providers are properly credentialed and recredentialed in compliance with internal policies, regulatory standards, and payer requirements. This role plays a key part in maintaining provider eligibility, protecting organizational integrity, and ensuring efficient, accurate credentialing processes.

Requirements

Associate’s or bachelor’s degree in healthcare administration, Business, or related field preferred.
Minimum of 10 years of experience in healthcare credentialing, with at least 1 year in a supervisory or lead role.
Strong knowledge of credentialing standards, healthcare standards and payer requirements (Medicare, Medicaid, Healthcare insurers).
Experience with credentialing software/systems (e.g., CAQH, Modio OneApp, Echo, etc.).
Strong attention to detail and accuracy in record-keeping.
Excellent organizational and time management skills.
Effective communication and leadership abilities.
Ability to prioritize and handle multiple tasks in a fast-paced environment.
Proficient in Microsoft Office Suite (Word, Excel, Outlook).

Responsibilities

Supervise and provide guidance to the credentialing staff, ensuring timely and accurate completion of all credentialing and recredentialing applications.
Monitor credentialing timelines and performance metrics, prioritizing tasks to meet payer and regulatory deadlines.
Review provider applications and support documentation for accuracy and completeness.
Collaborate with internal departments such as Human Resources, Provider Relations, and Revenue Cycle to ensure smooth onboarding and credentialing of new providers.
Maintain provider credentialing files and databases in accordance with organizational and accreditation standards (e.g., NCQA, TJC).
Resolve discrepancies, follow up with providers for missing information, and address any issues or delays in credentialing workflows.
Prepare for and participate in internal audits, external audits, and accreditation reviews.
Stay current with applicable laws, regulations, and payer requirements affecting credentialing.
Train, mentor, and evaluate credentialing team performance; identify areas for process improvement.
Assist in the development and implementation of credentialing policies and procedures.
Perform related duties as required.