Credentialing Manager Infusion Pharmacy
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Job Location:
Englewood, CO - USA
Yearly Salary:
$ 85000 - 120000
Posted on:
12 hours ago
Vacancies:
1 Vacancy
Job Summary
Our Company
Amerita
Overview
The Credentialing Manager leads and oversees enterprise-wide credentialing and recredentialing operations for pharmacies ambulatory infusion suites and nurse practitioner services across multiple states. This role ensures full compliance with federal state accreditation and payor-specific credentialing requirements in a highly regulated healthcare environment while supporting organizational growth and operational excellence
Schedule:
Monday - Friday 8:30am-5pm - Remote
We Offer
Medical Dental & Vision Benefits plus HSA & FSA Savings Accounts
Supplemental Coverage Accident Critical Illness and Hospital Indemnity Insurance
401(k) Retirement Plan
Company paid Life and AD&D Insurance Short-Term and Long-Term Disability
Employee Discounts
Tuition Reimbursement
Paid Time Off & Holidays
Responsibilities
- Manages day-to-day credentialing workflows for providers and facilities including onboarding recredentialing and change management
- Supervises mentors and develops credentialing specialists to ensure accuracy timeliness and consistency across all markets
- Serves as the subject matter expert on credentialing standards related to home infusion therapy specialty pharmacy and ambulatory services
- Maintains compliance with CMS state Medicaid agencies commercial payors and accreditation bodies (e.g. ACHC URAC The Joint Commission NABP)
- Partners with contracting revenue cycle compliance legal and clinical leadership to support new business acquisitions and market expansion
- Oversees credentialing for multi-state licensure DEA registrations NPI enrollment and specialty pharmacy-specific requirements
- Monitors credentialing metrics turnaround times and payor performance; identify risks and implement process improvements
- Leads audits corrective action plans and payor inquiries related to credentialing and enrollment
- Ensures credentialing data integrity within credentialing systems payor portals and internal provider databases
- Develops maintains and updates credentialing policies procedures and internal controls
- Scales credentialing operations to support acquisitions de novos and rapid geographic expansion
- Standardizes credentialing practices across regions while adapting to state-specific regulatory nuances
- Drives automation technology adoption and workflow efficiencies to reduce cycle time administrative burden and revenue leakage
- Provides executive-level reporting on credentialing status risks capacity constraints and operational readiness
- Acts as a strategic advisor on credentialing implications for new service lines care models and clinical programs
- Supervisory Responsibility: Yes
Qualifications
- Bachelors Degree in healthcare administration business or a related field
- Minimum of five (5) years health care experience
- Extensive experience in healthcare credentialing enrollment or provider operations (home infusion specialty pharmacy or multi-state healthcare preferred).
- Proven leadership experience managing credentialing teams in a complex payor-driven environment.
- Deep understanding of Medicare Medicaid and commercial payor credentialing and enrollment requirements.
- Strong analytical organizational and cross-functional communication skills.
- Demonstrated ability to lead in a fast-paced highly regulated healthcare setting
- Percentage of Travel: 0-25%
**To perform this role will require frequently sitting standing walking and typing on a keyboard with fingers and occasionally bending reaching and climbing (stairs/ladders). The physical requirements will be the ability to push/pull 1-10 lbs and lift/carry 21-30 lbs**
About our Line of Business
Salary Range
Required Experience:
Manager
Key Skills
- IT Experience
- LTC Pharmacy
- Hospital Experience
- Pharmacy Software
- Infusion Experience
- Management Experience
- Pharmacy Residency
- Training & Development
- Pharmacy Technician Experience
- Supervising Experience
- Clinical Pharmacy Experience
- Compounding Medications
About Company
BrightSpring Health Services is a leading provider of comprehensive home and community-based health services to complex populations.
