Credentialing and Licensing Manager

Position Summary

Verifies, tracks, and maintains current licensure and certification for all medical record reviewers and consultative examination providers, and monitors provider conduct standards.

Key Responsibilities

• Verify and maintain documentation of DC Board of Medicine certification/eligibility and licensure for all medical record reviewers prior to assignment.
• Track license renewal dates for all providers and proactively manage re-credentialing to prevent lapses.
• Maintain responsibility for ensuring examining providers keep required licenses current throughout the contract term.
• Monitor and reinforce standards requiring that providers treat claimants with courtesy, dignity, and respect.
• Maintain the credentialing file system for audit and District review.

Minimum Qualifications

• Bachelor's degree in healthcare administration or related field.
• 3+ years of experience in medical staff credentialing or provider enrollment.
• Familiarity with DC medical licensure requirements and provider credentialing databases.