NJ Licensed Credentialing Director

Job Summary

Seeking a strategic and experienced NJ Licensed Credentialing Director, the full-time position will manage provider credentialing, enrollment, compliance, and accreditation activities across a multi-state organization, ensuring adherence to regulatory requirements while fostering operational excellence in a flexible remote work environment.

Key Responsibilities

• Oversee provider credentialing and recredentialing operations across multiple states, ensuring compliance with federal and state regulations
• Lead contracting and enrollment initiatives with various payer organizations and maintain strong relationships with stakeholders
• Develop and implement policies, procedures, and performance metrics for credentialing and compliance functions

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Public Health, or a related field; Master's degree preferred
• Minimum of 7 years of experience in provider credentialing, healthcare compliance, or payer contracting
• Proficiency with credentialing and provider enrollment platforms, such as CAQH and NPPES
• Demonstrated experience with multi-state provider credentialing and payer enrollment operations
• Strong knowledge of Medicaid, Medicare, and commercial payer credentialing requirements