Senior Risk Adjustment Coder – Government Programs
Capital Blue Cross
Credentialing and Compliance Program Manager – Federal Healthcare Staffing
Cynet India
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
Lead
About the role
- Oversee credentialing, compliance, and onboarding for federal healthcare staffing programs (VA, DoD, IHS, DOJ)
- Act as senior liaison with client credentialing departments, CORs, and prime contractors
- Ensure candidate packages meet contract thresholds (≥92% acceptance, 10/18 day cycle times, ≤2 late/error MPSRs per month)
- Build and maintain dashboards to monitor credentialing performance, timeliness, and compliance
- Provide training and process oversight to Program Support Specialists and credentialing staff
- Conduct quality control checks on candidate files and escalate background hits, drug screen failures, adverse licensure outcomes
- Coordinate with recruiters/Program Support Specialists to ensure timely onboarding and candidate flow
- Manage escalations, implement corrective actions, and lead audit preparation to maintain audit-ready documentation
- Promote change management, process improvement, and scalable credentialing practices
- Mentor Program Support Specialists and serve as quality gatekeeper for candidate submissions
Requirements
- Minimum 8 years of experience in healthcare credentialing, compliance, or program operations (federal healthcare staffing strongly preferred)
- Demonstrated experience ensuring compliance with Service Contract Act (SCA) requirements, federal staffing regulations, and contract deliverables
- Proven leadership experience managing credentialing/compliance teams or operations
- Strong knowledge of VA/DoD credentialing requirements and standards (VHA directives, Joint Commission, NCQA, DHA)
- Skilled in navigating credentialing databases, vendor portals, and compliance trackers
- Excellent organizational, analytical, and communication skills
- Ability to work effectively in a deadline-driven, audit-focused environment
- Bachelor’s degree preferred; CPCS, CPMSM, or related certifications preferred
