Manager – Provider Payer Enrollment and Credentialing

Work from home Full-time role Hiring

Job Description:

Lead and oversee provider enrollment and credentialing operations.
Manage and develop Credentialing Coordinators, Supervisor, and Provider Recruitment Coordinator.
Serve as subject matter expert for provider credentialing, payer enrollment, and delegated credentialing.
Design and implement process improvements to enhance accuracy, timeliness, and operational efficiency.
Establish and manage delegated credentialing processes in compliance with NCQA, CMS, and regulatory standards.
Monitor performance metrics, analyze trends, and deliver actionable reports to leadership.
Partner with Finance, Operations, Practice Leaders, and executive stakeholders to prevent revenue leakage.
Ensure full compliance with federal, state, payer, and Trinity Health policies.

Requirements:

Bachelor’s degree in a related field or equivalent experience required.
5–7 years of progressive experience in provider enrollment, credentialing, or revenue cycle operations.
3–5 years of management experience in a healthcare or multi-facility environment, integrated health care delivery system, revenue cycle, or consulting experience.
2–4 years of delegated credentialing experience preferred.
Strong knowledge of payer enrollment regulations, provider documentation, and front-end revenue cycle functions.
Proficiency in Microsoft Office (Excel, Word, PowerPoint, Outlook).
Healthcare certification (HFMA, MGMA, LEAN, or similar) preferred.

Benefits:

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