Director, Credentialing and Enrollment

📋 Description

• Define and execute a long-term credentialing strategy to scale operations.
• Lead and mentor the Credentialing & Enrollment team.
• Transition from manual to tech-enabled workflows for faster onboarding.
• Ensure 100% compliance with NCQA, URAC, and CMS standards.
• Manage delegated credentialing agreements and CMS/private payer relations.
• Collaborate with Sales, Clinical Quality, and Operations to optimize processes.

🎯 Requirements

• 7+ years in healthcare ops; 3+ years leading Credentialing/Payer Enrollment.
• Multi-state licensure and enrollment oversight for telehealth providers.
• Deep knowledge: NCQA, CMS, CAQH, PECOS, NPPES, NPDB, SAM.
• Proficient in Excel/Sheets; credentialing software (e.g., Medallion).
• Bachelor's degree; CPCS/CPMSM preferred.
• Strong PM, communication, and teamwork skills.

🎁 Benefits

• Remote-first company culture.
• Flexible unlimited PTO.
• Healthcare coverage (Medical, Dental, Vision).
• 401k and FSA.
• Equal opportunity employer.