Remote Regulatory Affairs Lead

Overview Job Description - Credentialing Program Lead,Remote (250002J4)The HSCSN Credentialing Program Manager manages the Health Plan's provider credentialing activities, provider data management, and data reporting functions. The Credentialing Program Lead develops, performs and tracks the credentialing and recredentialing process and ensures activities meet Health Plan regulatory and contractual guidelines. This includes the management and performance oversight of Provider Credentialing delegates to ensure compliance with Health Plan and Medicaid market contract requirements.Additionally, the Program Lead is responsible for managing the Health Plan's online and published provider directory process. ResponsibilitiesThe HSCSN Credentialing Program Manager oversees:Provider credentialing and recredentialing processes and performance management of credentialing delegates to ensure compliance with Health Plan and Medicaid market contract requirements. Provider data management and data reporting functions. Online and published provider directory processes. Qualifications Minimum Education : Bachelor's Degree (Preferred)Minimum Work Experience : 10 years progressive experience in managed care provider credentialing, with at minimum, exposure to healthcare credentialing (Required)Required Skills/Knowledge : Proficiency in MS Word and Windows; experience in credentialing systems and databases such as CACTUS or other; proficiency in MS Excel and ability to manage provider demographics and other provider data sets; understanding of Medicaid contracts, market and other regulatory requirements related to provider networks, geographical access and credentialing requirements.Job Functions / Organizational Accountabilities Job FunctionsOrganizational Accountabilities (Managers) — Leadership ExcellenceLeadership SkillsAdditional Details Supervisory ResponsibilitiesBlood Borne Pathogen ExposureProtected Health Information Access LevelWorking EnvironmentPhysical RequirementsTravel RequirementsLocations Primary Location : District of Columbia-WashingtonWork Locations : HSCSN - Vermont Ave 1101 Vermont Ave NW Washington 20005Job Details Position Status : R (Regular) - FT - Full-TimeShift : DayJob Posting : Oct 3, 2025, 7:43:21 PMFull-TimeSalary Range : 62088 - 103480Health Services for Children with Special Needs (HSCSN) is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law.The “KnowYour Rights” poster and pay transparency policy are available here: KnowYour Rights / Pay Transparency / Nondiscrimination Poster. Please note that it is the policy of Health Services for Children with Special Needs (HSCSN) to ensure a “drug-free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors).Though recreational and medical marijuana are now legal in the District of Columbia, HSCSN maintains the right, in accordance with our policy, to enforce a drug-free workplace, including prohibiting recreational or prescribed marijuana. Note:This description reflects the role as posted. It does not imply current employment status or guarantee a vacancy. #J-18808-Ljbffr Children's National Medical Center Apply tot his job