Director of Provider Enrollment

Job Summary

Leading provider enrollment operations in a fully remote capacity, the full-time Director of Provider Enrollment will ensure accurate onboarding, contract implementation, and regulatory compliance while driving operational efficiency and data accuracy across the health plan.

Key responsibilities

• Oversee end-to-end provider enrollment from contract execution to activation, ensuring timely onboarding of all contracted providers
• Manage delegated credentialing processes and establish governance for provider data accuracy and compliance
• Lead the development of policies and workflows for non-participating provider management and ensure alignment with claims and network operations

Required qualifications

• 10+ years of healthcare operations experience within a health plan or managed care organization
• 5+ years of leadership experience in provider enrollment, credentialing, or related functions
• Bachelor's degree in healthcare administration, Business Administration, Public Health, or a related field
• Demonstrated experience managing delegated credentialing programs and provider roster governance
• Strong knowledge of CMS and NCQA requirements and provider data management processes