Kids Are Our Everything. Department 10521 HSCSN - Provider Affairs Pay Range $85,404.80 - $142,334.40 The Credentialing and Provider Data Manager is responsible for overseeing all aspects of provider credentialing, recredentialing and the integrity of provider data within the health plan. This includes ensuring compliance with federal and state regulations, accreditation standards (e.g., NCQA, CMS, DOH), and contractual obligations. The role provides leadership for credentialing and provider data management operations, including process development, data quality, delegated oversight, provider data management, provider directory management and audit readiness. The Manager will also serve as the point of contact for credentialing-related audits and ensure timely, accurate updates to provider directories and databases. The Manager supervises the Provider Data Specialist and Credentialing Coordinators. Minimum Education Bachelor's Degree (Preferred) Minimum Work Experience 7 years Credentialing experience (Required) And 5 years Supervisory or management experience (Required) Required Skills/Knowledge Excellent written and verbal communication skills Strong presentation skills In-depth knowledge of health plan and medical staff credentialing practices Strong familiarity with accreditation standards and regulatory frameworks (e.g., NCQA, JC, AAAHC, CMS, DHCF) Proven ability to improve process efficiency and implement system automation Experience with credentialing software and provider data systems Ability to interpret documents, licenses, certifications, and accrediation standards Ability to manage multiple priorities in a fast-paced environment Required Licenses and Certifications Certified Provider Credentialing Specialist (CPCS) 1 Year (Required) Job Functions Organizational Accountabilities Organizational Accountabilities (Managers) Leadership Excellence Collaboration Leadership Skills Supervisory Responsibilities Blood Borne Pathogen Exposure Protected Health Information Access Level Working Environment Physical Requirements Travel Requirements This additional job description is currently unavailable. Please connect with your HR Business Partner to discuss. The disclosed salary range includes the minimum and maximum rates within which Children’s National believes an individual’s base pay rate will fall for this position. It is not typical for an individual to be hired at or near the maximum of the pay range. The exact pay rate for this position will be based on a variety of factors in alignment with the Children’s National compensation philosophy. These factors are legitimate and non-discriminatory including, but not limited to, the current market conditions; organizational needs; the individual’s combination of prior work experience, level of education, knowledge, skills, and other qualifications. Children’s National is committed to providing a fair and competitive total rewards package to each of our employees. This base salary range does not include our comprehensive benefits package or any additional compensation for which this position may be eligible. Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law. The “Know Your Rights” poster is available here: and the pay transparency policy is available here: Know Your RightsPay Transparency Nondiscrimination Poster. Please note that it is the policy of Children's National Hospital to ensure a “drug-free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children's National and its affiliates maintain the right, in accordance with our policy, to enforce a drug-free workplace, including prohibiting recreational or prescribed marijuana. Thank you for your interest in joining our exceptional team at Health Services for Children with Special Needs, Inc. (HSCSN). We are committed to providing the personalized attention and high-quality care our enrollees need to lead fulfilling lives. Introduce yourself to our recruiting team, and we will reach out to you if a role aligns with your skills and experience. About Us Health Services for Children with Special Needs, Inc. (HSCSN) is the managed care plan contracted with the District of Columbia to administer the Child and Adolescent Supplemental Security Income Program (CASSIP) for children and young adults to age 26 years. HSCSN's mission is to coordinate innovative, high-quality, community-based care for individuals with complex needs and their families. HSCSN empowers all we serve to improve the quality of their lives. For more information about HSCSN, visit the website: HSCSN Health Services for Children with Special Needs | Health Services for Children with Special Needs, Inc. (HSCSN) (hscsnhealthplan.org) Recruitment Fraud Notice As fraudulent recruitment activities by individuals or organizations falsely claiming to represent hospitals are on the rise. Please be advised that: Official Communication: All legitimate communication regarding job opportunities will come from our official email addresses and website. Any correspondence related to Health Services for Children with Special Needs, Inc. from a personal email such as Yahoo, Gmail, iCloud, etc. is fraudulent. Application Process: We will never ask for payment or personal financial information as part of the recruitment process. All applications will be submitted through our applicant tracking system and can be found on our careers site. Careers. Verification: If you receive any suspicious communication, please verify its authenticity by contacting us directly at talentacquisitionconsultants @childrensnational.org Your safety and security are our priority. If you suspect recruitment fraud, report it to us immediately.

HSCSN Mgr Cred Prov Data Mgmt.

more at Childrensnational.

Social Worker Care Manager I

RN Care Manager

HSCSN RN Care Manager

similar roles.

Full-Time Mentor - Adult Day Services - M-F Days

Licensed Vocational Nurse