Supervisor Credentialing
At SCA Health, we believe health care is about people – the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000+ professionals working together, learning from each other and living out the mission, vision and values that define our organization.
As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.
What sets SCA Health apart isn’t just what we do, it’s how we do it. Each decision we make is rooted in seven core values:
- Clinical quality
- Integrity
- Service excellence
- Teamwork
- Accountability
- Continuous improvement
- Inclusion
Our values aren’t empty words – they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you’ll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.
At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Please visit, https://careers.sca.health/why-sca, to learn more about our benefits.
Your ideas should inspire change. If you join our team, they will.
Responsibilities
** The work schedule will be Monday - Friday with hours anywhere between 8am - 5:30pm EST / 7am - 4:30pm CST **
The Facility Credentialing and Payer Enrollment Supervisor oversees and manages the credentialing and payer enrollment processes for healthcare providers. This position ensures that all providers are appropriately credentialed with insurance payers, complies with all regulatory requirements, and maintains up-to-date records in accordance with company and payer guidelines. The manager also works closely with internal and external stakeholders to streamline the credentialing and enrollment processes and improve operational efficiencies.
Key Responsibilities:
- Oversee the credentialing and recredentialing process for all anesthesia providers and facilities according to the payer, state, and accreditation standards.
- Ensure that all necessary documentation (e.g., applications, verification of licensure, malpractice insurance) are up to date in credentialing database
- Work closely with contracting department on new agreements, and ensure all necessary documents are provided to the payer timely for contract execution
- Collaborate with Revenue Cycle, compliance and contracting to align credentialing and enrollment processes with billing and reimbursement requirements.
- Maintain payer relationships and escalate credentialing issues to payer leadership
- Stay updated with payer requirements, regulations, and industry trends to ensure all credentialing and enrollment processes comply with federal, state, and payer regulations
- Review all applications prior to being sent out to payers
- Lead, supervise, and train a team of credentialing and payer enrollment staff
- Analyze trends and issues in the credentialing and enrollment processes to develop strategies for improvement
- Develop and maintain standard operating procedures for credentialing and payer enrollment workflows
- Identify areas for improvement in the credentialing and payer enrollment process and develop efficient solutions
Qualifications
- High School Diploma or GED is required
- Bachelor's degree in healthcare administration, business, or a related field is preferred
- Minimum of 3-5 years of experience in credentialing, payer enrollment, or healthcare operations
- Must have at least 2 years experience in a Supervisor or managerial role
- Strong understanding of payer requirements, credentialing processes, and healthcare compliance regulations (e.g., CAQH, Availity, CMS guidelines)
- Ability to effectively manage a team and prioritize tasks in a fast-paced environment
- Strong organizational and time management skills