Multi-State Credentialing Lead

Job Summary

Owning the multi-state provider enrollment strategy, the full-time Credentialing & Enrollment Lead will manage end-to-end applications for Medicare Advantage, Medicaid, and Original Medicare, while shaping payer relationships and contracting in a remote environment.

Key responsibilities

• Own provider enrollment processes across multiple states, including applications, follow-ups, and issue resolution
• Lead the credentialing strategy utilizing CAQH, PECOS, and state Medicaid portals
• Navigate payer contracting by understanding fee schedules, timelines, and negotiable terms

Required qualifications

• Experience with multi-state telehealth credentialing, not just in-person enrollment
• Understanding of PC-MSO structures and their impact on payer enrollment
• Direct experience with Medicare Advantage payers and state Medicaid programs
• Familiarity with CAQH, PECOS, and multiple state Medicaid portals
• Experience in payer contracting post-credentialing processes