Credentialing Manager

Job Summary

A company is looking for a Credentialing Manager to lead the credentialing, privileging, and payer enrollment functions for their Managed Service Organization.

Key Responsibilities

• Oversee the full lifecycle of credentialing, re-credentialing, and payer enrollment for all providers
• Manage complex and escalated credentialing cases while leading a credentialing team
• Design and implement scalable credentialing workflows and monitor performance metrics

Required Qualifications

• Bachelor's degree preferred; relevant experience may substitute
• CPCS certification strongly preferred
• Minimum three years of credentialing experience, including payer enrollment and privileging
• Prior supervisory or team lead experience required
• Strong knowledge of NCQA, CMS, and payer credentialing standards