Schedule: Monday – Friday | 9:00 AM – 6:00 PM EST
Employment Type: Full-Time
Industry: Healthcare Credentialing & Provider Enrollment
About the Prospect
A rapidly growing healthcare services organization is seeking an experienced Credentialing & Enrollment Manager to lead provider credentialing, payer enrollment, and contracting operations across multiple states and payer networks.
The ideal candidate will have extensive experience managing provider enrollment projects, working directly with commercial and government payers, and leading a credentialing team in a fast-paced healthcare environment.
This is a fully remote position with long-term growth opportunities for professionals who are passionate about operational excellence and healthcare compliance.
Key Responsibilities
- Manage end-to-end provider credentialing and enrollment processes.
- Oversee Medicare, Medicaid, and Commercial Insurance enrollments.
- Ensure timely submission and follow-up of provider applications.
- Manage CAQH, PECOS, NPPES, and payer portal updates.
- Track credentialing status and maintain accurate provider records.
- Coordinate with providers, payers, and internal stakeholders.
- Handle recredentialing, demographic updates, and provider maintenance.
- Monitor enrollment timelines and resolve application delays.
- Develop and improve credentialing workflows and SOPs.
- Lead, train, and mentor credentialing specialists.
- Ensure compliance with payer, state, and federal requirements.
- Prepare credentialing reports, dashboards, and performance metrics.
Required Qualifications
- 7+ years of healthcare credentialing and provider enrollment experience.
- 2+ years of leadership or team management experience.
- Strong knowledge of:
- Medicare Enrollment
- Medicaid Enrollment
- Commercial Payer Credentialing
- CAQH
- PECOS
- NPPES
- Availity
- Provider Contracting
- Experience working with multi-state provider enrollments.
- Excellent comm