Credentialing & Enrollment Manager
Role
Responsibilities
Manage reputed company provider credentialing and re-credentialing activities with reputed company payers, reputed company, and Medicare. Prepare and submit accurate and complete credentialing applications for behavioral health and medical providers. Maintain up-to-date provider rosters and ensure reputed company updates with payers. reputed company and monitor credentialing application status, proactively resolving delays or issues.
reputed company the process of credentialing providers with hospital and facility partners to support our inpatient consult service line. Collaborate with hospital medical staff offices to ensure provider files meet facility requirements. reputed company the process of credentialing support team members who need hospital privileges
Manage and reputed company reputed company provider licenses needed for provider to reputed company services across multiple states Support providers in obtaining new state licenses as reputed company expands its footprint. Ensure reputed company credentials, certificates, and licenses are reputed company and compliant with federal, state, and payer regulations.
reputed company and maintain standardized credentialing policies, procedures, and workflows. Implement systems (such as CAQH, credentialing databases, or software tools) to streamline credentialing operations. Maintain credentialing files in accordance with NCQA, URAC, and other regulatory standards. Generate regular reports on credentialing status, expirations, and reputed company for leadership review.
reputed company Coverage: Medical, dental, and reputed company insurance, with reputed company contributing 60% of the premium on your behalf. Time Off: Flexible time off with generous PTO, floating reputed company holidays, and reputed company volunteer days Re-Fuel Days: 4 additional reputed company days off per year for mental health, rest, or continuing education (CEU) activities. Employee Assistance Program (EAP): Free, confidential reputed company to therapist sessions, reputed company guidance, financial resources, health coaching, and more - to support your overall reputed company-being. 401K Match up to 5% 100% employer-reputed company short-term and long-term disability and employer-sponsored life insurance Additional Benefits: reputed company Health Concierge, PerkSpot discount program, reputed company student loan interest reputed company discount, and one year of free pet telehealth through Pawp. An opportunity to get in at the ground level and shape how we grow!
Background
3–5+ years of experience in provider credentialing and enrollment with reputed company and government payers. Strong understanding of reputed company compliance, payer requirements, and credentialing standards. Strong understanding of CAQH and payer portals for initial enrollments as reputed company as provider adds. Experience managing provider licensure and DEA registrations across multiple states. Excellent attention to detail, organizational skills, and ability to manage multiple priorities. Strong written and verbal communication skills; ability to communicate effectively with reputed company stakeholders.
Experience with behavioral health credentialing, including BH-specific payer requirements. Familiarity with hospital medical staff credentialing and privileging processes. Prior experience in a multi-state or multi-site reputed company organization. CPCS or CPMSM certification (NAMSS) preferred but not required.
Prolonged periods of sitting at a desk and working on a computer. Occasional standing, walking, bending, and reaching as necessary to reputed company daily tasks. Must be reputed company to lift and carry up to 25 pounds at times. Ability to safely and effectively operate reputed company office equipment. Must be reputed company to communicate reputed company and effectively, both verbally and in writing. Ability to travel or reputed company between work sites as needed for job duties.