Director of Credentialing and Payer Enablement

Job Summary

To support the strategic leadership and continuous improvement of credentialing and payer enablement functions, the full-time Director of Credentialing and Payer Enablement will oversee payer enrollment, portal management, and ensure compliance with regulatory requirements while working remotely.

Key Responsibilities

• Develop and execute the credentialing and payer enablement strategy, including performance goals and operational excellence
• Oversee credentialing, recredentialing, and payer enrollment activities, ensuring timely completion and improvements in turnaround times
• Manage payer portal administration and vendor performance to ensure successful payer implementation and reimbursement readiness

Required Qualifications

• Bachelor's or Associate degree preferred; or High School Diploma/GED with 10+ years of progressive healthcare operations experience
• 10+ years of experience in credentialing, provider enrollment, or payer operations
• 5+ years of leadership experience managing teams and operational performance
• Extensive experience with Medicare, Medicaid, and commercial payer enrollment processes
• Proven success in managing payer portals and payer enablement functions