Illinois Licensed Credentialing Manager

Job Summary

To oversee credentialing and payer enrollment operations for providers, the full-time Illinois Licensed Credentialing Manager will establish compliant processes, manage relationships with partners, and ensure audit-ready provider files in a remote setting.

Key responsibilities

• Lead initial credentialing and re-credentialing cycles, ensuring compliance with NCQA standards and maintaining accurate provider files
• Manage payer enrollment processes and coordinate with various departments to align credentialing with licensure and clinic readiness milestones
• Conduct audits and support accreditation readiness activities, implementing corrective actions for identified gaps

Required qualifications

• Bachelor's degree in healthcare administration, nursing, business, public health, or a related field
• Five or more years of experience in healthcare provider credentialing and payer enrollment
• Demonstrated experience leading credentialing workflows and managing sensitive provider information
• Working knowledge of NCQA credentialing standards and healthcare regulatory expectations
• Strong proficiency with spreadsheets, reporting tools, and credentialing platforms