Search

Credentialing Manager

PublishedPublished: 6/14/2022
Healthcare

Job Description

Job DescriptionSalary: $80,000-$90,000 annually

Position Summary

The Credentialing Manager is responsible for leading and executing all aspects of provider credentialing, payer enrollment, and payer contracting. This role serves as both a strategic leader and a hands-on contributor, ensuring credentialing operations are efficient, compliant, and aligned with provider onboarding timelines.


The ideal candidate brings prior experience as a credentialing lead or manager and has deep expertise in resolving complex enrollment and contracting issues, driving timelines, and supporting organizational growth.


Key Responsibilities

Leadership & Execution

Lead, mentor, and support the credentialing team while maintaining a hands-on role in daily operations

Act as a working manager, stepping in to complete credentialing, enrollment, and contracting tasks as needed

Set clear expectations, monitor performance, and ensure accountability to timelines


Credentialing & Payer Enrollment

Oversee and actively manage end-to-end provider credentialing and recredentialing processes

Lead payer enrollment activities including initial enrollments, revalidations, updates, and terminations

Ensure compliance with all payer, state, and federal requirements


Payer Contracting

Manage and support payer contracting processes, including applications, follow-up, and execution

Track and drive contract timelines to ensure providers are in-network as quickly as possible

Partner with leadership on payer participation and network strategy


Strategy, Timelines & Process Improvement

Develop and manage credentialing and enrollment timelines aligned with provider start dates

Identify bottlenecks and implement process improvements to increase efficiency and reduce delays

Build tracking and reporting mechanisms to provide visibility into credentialing status and risks


Problem-Solving & Escalations

Serve as the escalation point for complex or stalled credentialing, enrollment, or contracting issues

Proactively identify risks and implement solutions to prevent delays

Build and leverage payer relationships to resolve issues effectively


Qualifications

Required

5+ years of credentialing experience, including experience 2+ years in a supervisory or management role.

Direct experience with payer enrollment and payer contracting

Strong working knowledge of credentialing processes, compliance requirements, and payer systems

Demonstrated ability to manage timelines and resolve complex credentialing and enrollment issues

Experience leading or mentoring team members


Preferred

Experience credentialing providers in Minnesota, South Dakota, and Wisconsin

Multi-state credentialing experience

Experience in a high-growth or multi-site healthcare organization

Familiarity with CAQH and credentialing/enrollment platforms


Key Competencies

Hands-on, roll-up-your-sleeves leadership approach

Strong problem-solving and critical thinking skills

Ability to manage competing priorities and tight timelines

High attention to detail and accuracy

Effective cross-functional communication


Success Measures

Providers credentialed and enrolled in alignment with start dates

Reduction in enrollment and contracting delays

Efficient resolution of payer issues and escalations

Accurate, compliant credentialing records

Strong team performance and accountability


EEO Statement:

The Remedy Mental Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, or any other protected status.


Disclaimer:

This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the position. Duties may change based on business needs.


Work Authorization Requirement:
All candidates must be legally authorized to work in the United States. The company does not currently sponsor employment visas.

Loading...
Loading...
Loading...
Loading...
Loading...
Loading...
Loading...
Loading...
Loading...
Loading...
Loading...
Loading...