California Credentialing Manager

Job Summary

A company is looking for a Manager, Credentialing & Network Specialist.

Key Responsibilities

• Own end-to-end provider credentialing and enrollment across multiple payers, ensuring compliance and timely completion
• Maintain audit-ready credentialing files and documentation to support compliance checks and payer reviews
• Build and improve credentialing infrastructure, including SOPs, policies, and tracking systems

Required Qualifications

• 5+ years of experience in provider credentialing, enrollment, or healthcare network operations
• Hands-on experience managing CAQH profiles
• Experience credentialing providers across Medicaid and Medicare, with a preference for Medicare Advantage and D-SNP
• Proven ability to build repeatable systems in a scaling environment
• Prior experience supporting payer audits or readiness assessments