Manager, Provider Credentialing- Charlotte, NC

OrthoCarolina•Charlotte, NC

10d

About The Position

OrthoCarolina is seeking a Manager of Provider Support Services to join its Provider Credentialing team in Charlotte, North Carolina. This role provides strategic leadership, operational management, compliance oversight, and continuous improvement for provider credentialing, delegated credentialing, payer enrollment, privileging, onboarding, provider data management, training, audit readiness, and provider support services. The manager leads and develops the team, oversees day-to-day operations and performance, ensures compliance with applicable requirements, and collaborates with internal and external partners to support provider readiness and service delivery.

Requirements

Bachelor’s degree in Healthcare Administration, Business Administration, Human Resources, or a related field preferred; equivalent education and relevant experience may be considered.
At least 5 years of progressively responsible experience in credentialing, provider enrollment, medical staff services, or healthcare operations.
At least 3 years of management, supervisory, or team leadership experience.
Experience managing credentialing and provider enrollment functions within a healthcare organization.
Strong leadership, coaching, and team development skills.
Excellent organizational skills and the ability to manage multiple priorities and deadlines.
Strong knowledge of credentialing, payer enrollment, delegated credentialing, privileging, and healthcare compliance requirements.
Demonstrated problem-solving, critical-thinking, and process-improvement abilities.
Strong interpersonal and communication skills, including the ability to collaborate across departments and with external partners.
Advanced proficiency in Microsoft Excel and experience with Microsoft Teams, SharePoint, Outlook, Word, credentialing systems, and provider databases.
Ability to analyze data, develop reports and dashboards, and monitor operational performance.

Nice To Haves

Experience with delegated credentialing arrangements, payer audits, performance metrics, and operational improvement initiatives.

Responsibilities

Lead, coach, and develop the Provider Support Services team, ensuring accountability for quality, productivity, compliance, and service.
Oversee provider credentialing, recredentialing, primary source verification, payer enrollment, privileging, onboarding, and delegated credentialing activities.
Manage delegated credentialing programs, payer relationships, audits, reporting requirements, and corrective action plans.
Ensure compliance with payer, regulatory, accreditation, and organizational requirements.
Monitor department performance, workloads, timelines, and key performance indicators to ensure operational goals are achieved.
Partner with providers, leadership, hospitals, payers, Revenue Cycle, Managed Care, Compliance, HR, IT, and Operations to resolve issues and support provider readiness.
Identify and implement process improvements to increase efficiency, data accuracy, and service delivery.