Credentialing Operations Manager

Job Summary

The Credentialing & Payer Operations Manager will manage end-to-end provider licensing, payer enrollment, and credentialing operations in a full-time remote role, focusing on building scalable processes and maintaining regulatory compliance.

Key Responsibilities

• Manage full lifecycle licensing, credentialing, and re-credentialing applications for Care Team members across multiple states
• Establish and optimize internal credentialing and payer enrollment processes while maintaining the credentialing management platform
• Oversee the credentialing-to-claims bridge to ensure providers are linked to billing systems, preventing claim denials

Required Qualifications

• 5+ years of healthcare credentialing, provider operations, and payer enrollment experience
• Proven experience submitting state licensure applications across multiple states and tracking certification/CEU requirements
• Bachelor's degree in Healthcare Administration, Business, or related field (Associates degree accepted with equivalent hands-on experience)
• Hands-on experience with Medallion or similar credentialing tracking platforms is strongly preferred