R

Healthcare Compliance Manager

Reworks Solution
17 days ago
Full-time
Remote
South Africa
Auditing, Regulatory, Quality, and Compliance

Introduction

Job Title: Healthcare Compliance Manager

Location: Remote (South Africa)

Job Type: Full-Time

Working Hours: US Hours (9am - 5pm EST)

Salary: Paid in South African Rands (ZAR)

 

Overview

ReWorks Solutions is seeking a dedicated Credentialing Manager specializing in Applied Behavior Analysis (ABA) to lead and manage our credentialing operations. This role requires a proactive professional to ensure our providers meet all necessary credentialing requirements with insurance payers and regulatory bodies, maintaining compliance and facilitating smooth onboarding processes.

Key Responsibilities

  • Manage and lead the ABA credentialing team to ensure timely completion of credentialing and recredentialing tasks.
  • Maintain and develop relationships with insurance payers, providers, and regulatory agencies.
  • Stay current on ABA credentialing standards, payer policies, and regulatory requirements.
  • Identify and implement process improvements to increase efficiency.
  • Provide training and support for credentialing staff to uphold best practices.
  • Monitor credentialing metrics and generate regular compliance reports.
  • Coordinate with HR and leadership on provider onboarding and terminations relating to credentialing.
  • Handle audits and respond to credentialing inquiries from external entities.

 

Requirements:

  • Bachelor’s degree in healthcare administration, business, or related field preferred.
  • 3-5 years of experience in credentialing, preferably within ABA or behavioral health.
  • Leadership experience in managing credentialing teams or projects.
  • Strong understanding of insurance payer credentialing processes and regulatory compliance in ABA.
  • Excellent organizational, multitasking, and communication skills.
  • Proficiency with credentialing software, Microsoft Office, and database management.
  • Ability to work effectively in a remote environment and collaborate with a diverse team.

 

Benefits:

  1. Comfortable working U.S. hours
  2. Remote work from home

 

Fraud Disclaimer:  ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.