Credentialing Manager

Job Summary

Leading a team of credentialing specialists, the full-time remote Credentialing Manager will oversee the end-to-end delegated credentialing program, manage provider onboarding and compliance audits, and drive long-term credentialing strategy while collaborating cross-functionally to enhance operational efficiency.

Key responsibilities

• Lead, manage, and develop a team of 5+ credentialing specialists, ensuring performance against key metrics
• Own and operate the delegated credentialing program, including provider onboarding and maintaining NCQA standards
• Manage internal credentialing committee operations and oversee compliance audits to ensure adherence to regulatory requirements

Required qualifications

• Bachelor's degree
• 5+ years of experience in provider credentialing and/or health plan enrollment
• Direct experience operating a delegated credentialing program, including primary source verification and NCQA standards
• 2+ years of people management experience in a credentialing or enrollment team
• Familiarity with Medicaid and Commercial payor enrollment processes