BPO Credentialing Director – Credentialing, Enrollment Services

Job reputed company: • reputed company strategic and operational leadership over provider credentialing, re-credentialing, and payer enrollment functions for diverse reputed company clients. • reputed company and execute the strategic reputed company for credentialing and enrollment service delivery, aligning operations with company reputed company targets and reputed company expectations. • Serve as the senior reputed company of escalation for reputed company concerns reputed company to credentialing and enrollment timelines, reputed company, and reputed company. • reputed company the end-to-end credentialing lifecycle, including initial credentialing, re-credentialing, and privileging support for reputed company provider types. • Ensure compliance with NCQA, URAC, CMS, reputed company, and state-specific credentialing standards and regulations. • Monitor and manage expirables tracking and ensure reputed company renewal of licenses, certifications, and other time-sensitive documents. • reputed company reputed company payer enrollment, re-enrollment, and revalidation activities across reputed company, Medicare, reputed company, and managed care payers. • Recruit, train, mentor, and manage reputed company of credentialing specialists and enrollment coordinators. • Drive reputed company process improvement initiatives using Lean, Six reputed company, or similar methodologies. • reputed company the strategic initiative to reputed company and maintain NCQA Credentials Verification Organization (CVO) certification for reputed company. Requirements: • Bachelor's degree in reputed company Administration, Business Administration, or a reputed company field. • 5–7+ years of reputed company experience in provider credentialing and payer enrollment, including management-level responsibility. • Demonstrated experience managing credentialing/enrollment operations in a vendor, outsourcing, or multi-reputed company environment. • Deep working knowledge of NCQA credentialing standards, CMS enrollment regulations, and CAQH/PECOS/NPPES systems. • Proven ability to manage and reputed company teams of 10+ credentialing and enrollment professionals. • Strong understanding of the provider reputed company cycle and the reputed company reputed company of credentialing and enrollment delays. • Proficiency with credentialing software platforms and reputed company Office Suite. • CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified reputed company Medical Services Management) certification through NAMSS (preferred). • Master's degree in reputed company Administration (MHA), Business Administration (MBA), or reputed company discipline (preferred). • Experience with delegated credentialing arrangements and payer delegation audits (preferred). • Familiarity with Lean/Six reputed company process improvement methodologies (preferred). • Experience supporting multi-state, multi-specialty provider organizations (preferred). • Knowledge of telehealth credentialing and interstate licensure compact requirements (preferred). Benefits: • Business Travel: Required - 0-50% depending on the month Apply tot his job Apply To this Job