Manager, Ambulatory Credentialing, Sutter Health, Northern CA

Posted on March 27th, 2025

Job Posting Title:  Manager, Credentialing

Job Description Summary
Oversees the day-to-day operations and provides oversight of work assigned to the credentialing team. Responsible for managing work assignments, monitoring established goals, coaching and establishing performance plans. Performs routine audits to ensure compliance with department policies and Federal/State requirements. Takes a strategic and tactical approach in identifying best practices and standardizing workflows/processes and developing plans of action to implement changes.

Job Description

EDUCATION:

Equivalent experience will be accepted in lieu of the required degree or diploma.

Bachelor's: Business Administration, Healthcare or related field or equivalent education/experience

TYPICAL EXPERIENCE:

8 years recent relevant experience

SKILLS AND KNOWLEDGE:

• Must have knowledge of credentialing principals, particularly those associated with medical groups and insurance.
• Ability to oversee day-to-day credentialing and enrollment activities to ensure business goals are met.
• Requires the ability to work with and maintain confidential information.
• Proficient in Microsoft Word, Excel, Access and PowerPoint and Credentialing systems and applications.
• Ability to navigate credentialing information management systems to perform analysis and generate reports as needed.
• Demonstrated leadership skills, including team building, and coaching/mentoring with the ability to motivate and engage others.
• Ability to build and establish effective working partnership with employees, peers and/or leaders to achieve business objectives.
• Organizational and time management skills, with the ability to prioritize multiple projects while delivering quality service and achieving business results.
   

Strategy/Planning

• Maintains expertise by reading journals, manuals, articles and attending seminars or workshops pertaining to credentialing, enrollment and management. This is critical in order to maintain up-to-date awareness and understanding of applicable rules, regulations and standards required to maintain compliance.
• Stays abreast of the latest developments, best practices and trends in credential verification and other functional areas that may impact the organization and ensures appropriate implementation within the organization.
• Utilizes reporting tools to gain operational insight in order to identify and manage problems and propose resolutions
• Leads departmental goal setting process and provides roadmap for accomplishing goals. Monitors progress, developing action plans to address issues and challenges.
• Communicates affiliate, operating unit and system goals to staff, helping staff understand impact on operations and resources.
• Develops plan of action to address current and future resource needs in order to meet service and/or operational demands and objectives.

Financial Management

• Establishes and manages capital and operational budgets to achieve financial targets via effective utilization of personnel, resources and supplies.
• Monitors department productivity, ensuring operational challenges are addressed timely.
• Reviews financial reports and develops and implements corrective action plans to address unfavorable variances.

People

• Provides and fosters an inclusive work environment that encourages staff engagement and collaboration, establishing a culture of teamwork.
• Supervises assigned staff, makes hiring and termination decisions, and reviews and approves timekeeping records.
• Establishes expectations with all direct reports, holds individuals and work teams accountable, and ensures job descriptions accurately reflect job responsibilities and expectations.
• Evaluates staff performance and makes/recommends associated merit increase. Provides constructive feedback, coaching and counseling.
• Provides opportunities for career development, role expansion, and cross-training.
• Monitors department training and orientation plans, ensuring staff meets competency requirements and participates in appropriate education and training programs.
• Conducts staff meetings for informative and educational purposes.

Compensation: Salaried position (range 104-160k depending on experience), 401k matching, Annual Bonus, Full benefits

Link to Apply:  https://wd1.myworkdaysite.com/recruiting/sutterhealth/SH/job/Los-Altos/Manager--Credentialing_R-97198