Credentialing Manager

Bridgeview Eye Partners

. Manage and execute the end-to-end credentialing life cycle, including initial credentialing, recredentialing, and expiration tracking .

Posted 9/29/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing the credentialing life cycle, ensuring compliance with NCQA, CMS, and payer standards, while leading and developing teams to achieve operational excellence. Proficient in strategic relationship management and process improvement within the optometry/ophthalmology domain.

Highest-signal resume keywords

Credentialing ManagementSupervisory ExperienceCPCS CertificationKnowledge of CPT, ICD-10, and HCPCS CodesPayer Enrollment Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Credentialing Life Cycle ManagementPayer Enrollment ApplicationsCompliance MonitoringDatabase MaintenanceWorkflow DocumentationCPT CodingICD-10 CodingHCPCS CodingDelegated CredentialingManaged Care Contracting

Soft Skills

Advanced Communication SkillsInfluence & Negotiation SkillsCross-Functional CollaborationAttention to DetailProfessional Integrity

Tools & Technologies

Microsoft OfficeCredentialing Database

Certifications & Qualifications

CPCS CertificationCPMSM Certification

Industry Keywords

OptometryOphthalmologyOutpatient HealthcareNCQA ComplianceCMS Standards

About the role

Key responsibilities & impact

Manage and execute the end-to-end credentialing life cycle, including initial credentialing, recredentialing, and expiration tracking
Oversee payer enrollment applications, PECOS updates, CAQH maintenance, NPPES records, and delegated agreements
Monitor and ensure compliance with NCQA, CMS, and commercial payer standards
Maintain an accurate credentialing database
Lead, supervise, and support Provider Enrollment Specialists
Ensure timely submission and follow-up of applications
Establish, document, and refine credentialing workflows, SOPs, and KPIs
Act as primary liaison with insurance plans to resolve enrollment delays or issues
Stay current with payer policy updates and state/federal regulations
Support credentialing-file audits
Provide weekly and monthly updates on credentialing status and turnaround times
Track and report pending expirations to avoid lapses
Prepare credentialing rosters and enrollment summaries
Champion the company's culture and commitment to patient care
Align strategic goals and resources to maximize profitability
Collaborate across the organization to identify needs and develop scalable solutions
Work on integration and post-acquisition teams as needed
Drive operational excellence to achieve financial goals
Build and lead collaborative teams, develop people, and link performance to business objectives
Guide and evaluate the work of other employees
Recruit, hire, train, motivate, and retain current and future leaders
Perform other duties as assigned

Requirements

What you’ll need

Bachelor’s degree or equivalent experience required
3-5 years of credentialing experience
2+ years in a supervisory role
Experience in optometry/ophthalmology or outpatient healthcare preferred
Experience in delegated credentialing and/or managed care contracting preferred
CPCS or CPMSM certification preferred
Strategic Relationship Management
Advanced Communication Skills
Influence & Negotiation Skills
Cross-Functional Collaboration
Process Improvement & Problem Solving
Project & Time Management
Proficiency in Microsoft Office
Strong knowledge of CPT, ICD-10, and HCPCS codes relevant to optometry/ophthalmology
Knowledge of insurance guidelines relevant to optometry/ophthalmology
Attention to detail
Professional Integrity
Ability to communicate effectively through verbal and written means
Ability to hear and understand spoken information in-person and via electronic means
Visual acuity to ensure the accuracy of work performed on screens and in documents
Ability to maintain focus and attention to detail for extended periods

Benefits

Comp & perks

Remote position
Reasonable accommodations may be provided to qualified individuals with disabilities in accordance with applicable laws