Integrated Services of Appalachian Ohio

Manager

• Oversee all provider credentialing, recredentialing, payer enrollment, and provider maintenance activities for ISBH
• Manage the credentialing team and coordinate daily workflow to ensure the timely completion of credentialing activities
• Responsible for performance management, recruitment, onboarding, and team development, including but not limited to implementing progressive discipline when necessary
• Ensure timely submission, tracking, and follow-up of credentialing and recredentialing applications to prevent lapses in provider participation
• Maintain provider credentialing files and databases, ensuring all licenses, certifications, registrations, and other required documentation remain current.
• Monitor provider enrollment status with Ohio Medicaid, Medicare, commercial payers, and other contracted entities
• Serve as the primary resource for resolving complex credentialing and payer enrollment issues
• Ensure compliance with federal, state, accreditation, and payer-specific credentialing requirements
• Develop, implement, and maintain credentialing policies, procedures, and quality assurance standards
• Monitor credentialing performance metrics and identify opportunities for process improvement and operational efficiency
• Collaborate with billing, compliance, human resources, clinical leadership, and provider relations teams to support organizational goals
• Maintain expertise in credentialing regulations, payer requirements, provider enrollment processes, and industry best practices
• Coordinate credentialing activities related to new programs, services, locations, and revenue streams
• Participate in audits, accreditation reviews, and compliance activities as required
• Attend virtual and in-person internal and external training, conferences, and meetings as appropriate
• Maintain compliance with HIPAA, mandated reporting requirements, and professional ethical guidelines
• Travel within the designated service area
• Perform other duties as assigned.

Credentialing Manager

• Oversee all provider credentialing, recredentialing, payer enrollment, and provider maintenance activities for ISBH
• Manage the credentialing team and coordinate daily workflow to ensure the timely completion of credentialing activities
• Responsible for performance management, recruitment, onboarding, and team development, including but not limited to implementing progressive discipline when necessary
• Ensure timely submission, tracking, and follow-up of credentialing and recredentialing applications to prevent lapses in provider participation
• Maintain provider credentialing files and databases, ensuring all licenses, certifications, registrations, and other required documentation remain current.
• Monitor provider enrollment status with Ohio Medicaid, Medicare, commercial payers, and other contracted entities
• Serve as the primary resource for resolving complex credentialing and payer enrollment issues
• Ensure compliance with federal, state, accreditation, and payer-specific credentialing requirements
• Develop, implement, and maintain credentialing policies, procedures, and quality assurance standards
• Monitor credentialing performance metrics and identify opportunities for process improvement and operational efficiency
• Collaborate with billing, compliance, human resources, clinical leadership, and provider relations teams to support organizational goals
• Maintain expertise in credentialing regulations, payer requirements, provider enrollment processes, and industry best practices
• Coordinate credentialing activities related to new programs, services, locations, and revenue streams
• Participate in audits, accreditation reviews, and compliance activities as required
• Attend virtual and in-person internal and external training, conferences, and meetings as appropriate
• Maintain compliance with HIPAA, mandated reporting requirements, and professional ethical guidelines
• Travel within the designated service area
• Perform other duties as assigned