Credentialing Manager

📋 Description

• Own 10–15 payers end-to-end; SME on portal workflows, SLAs, escalations.
• Lead a team of Provider Enrollment Specialists; prioritize work and ensure quality.
• Audit and redesign credentialing workflows for scalable growth and automation.
• Define and own SLAs; track turnaround time, accuracy, denials, and resubmissions.
• Design credentialing workflows for net-new payer contracts and launches.
• Reports to Head of Credentialing.

🎯 Requirements

• 3+ years credentialing/enrollment with at least 2 in a lead/management role.
• Deep knowledge of CAQH ProView, NPDB, licensing databases, and major payer portals.
• Experience redesigning credentialing workflows across high-volume providers and national payers.
• Experience owning credentialing KPIs and payer health dashboards with SLA tracking.
• Strong understanding of credentialing impact on claims and revenue cycle; cross-functional coordination.
• Preferred: allied health credentialing experience.