Manager, Payor Credentialing

Manager, Payor Credentialing

Job Summary:

The Manager of Payer Credentialing is responsible for working on the day-to-day requirements of Payer Credentialing and Enrollments. This role requires a strong self-motivated work ethic, the ability to determine without guidance what needs to be worked on and prioritized, a deep understanding of payor enrollment, credentialing, re-credentialing, healthcare operations, change management, and the ability to implement processes. The Manager will partner with the team lead to focus on optimizing revenue, standardizing processes, building and maintaining strong payer relationships, and ensuring positive internal and external client experiences.

Essential Responsibilities/Duties:

● Holding a major role of responsibility with a high-performing payer credentialing team, fostering a culture of accountability, collaboration, and continuous improvement.

● Continuously evaluate and improve existing payer enrollment processes and systems, leveraging technology, vendors, and best practices to enhance quality and productivity.

● Monitor industry trends and regulatory changes to proactively adjust processes and ensure continued compliance.

● Comply with all State and Federal Laws regarding an effective Compliance Program, inclusive of HIPAA Privacy and Security.

● Adhere to the organization's Code of Conduct and be familiar with all compliance policies and procedures relevant to this position.

● Hold oneself accountable for completing all activities in a timely manner

Qualifications:

* Education:

- Bachelor's degree, required.

* Competencies/Skills:

- Demonstrated success in credentialing..

- Exceptional problem-solving skills and the ability to think strategically and execute operational initiatives.

- Strong communication, interpersonal, and leadership skills, with the ability to effectively manage cross-functional relationships.

- Proven track record in managing provider data management systems, client, and payer relationships.

* In-depth knowledge of credentialing processes, regulatory requirements, and healthcare industry standards.

* Experience:

* 5-7 years of Credentialing Management experience in a managed care or healthcare environment. Laboratory credentialing experience is required.

* Proficiency with MS Office, Adobe Acrobat, Google Workspace, and Salesforce applications. Monday.com, and Smartsheet software knowledge is a plus.

This job description is intended to outline the general nature and key responsibilities of the role. It is not an exhaustive list of all duties, responsibilities, or qualifications associated with the position. Responsibilities may evolve, and additional tasks may be assigned as business needs change, with or without prior notice.

The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.
Remote USA
$121,400—$151,700 USD

OUR OPPORTUNITY

Natera™ is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives.

The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other. When you join Natera, you’ll work hard and grow quickly. Working alongside the elite of the industry, you’ll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management.

WHAT WE OFFER

Competitive Benefits - Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, Natera employees and their immediate families receive free testing in addition to fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits and much more. We also offer a generous employee referral program!

For more information, visit www.natera.com.

Natera is proud to be an Equal Opportunity Employer. We are committed to ensuring a diverse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide.

All qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws.

If you are based in California, we encourage you to read this important information for California residents.

Link: https://www.natera.com/notice-of-data-collection-california-residents/

Please be advised that Natera will reach out to candidates with a @natera.com email domain ONLY. Email communications from all other domain names are not from Natera or its employees and are fraudulent. Natera does not request interviews via text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. Natera takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any related cyber crimes.

For more information:
- BBB announcement on job scams
- FBI Cyber Crime resource page