Manager – Provider Payer Enrollment and Credentialing
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:
• Day shift
• Remote
• Great benefits effective day 1!
• Competitive pay
• Mission driven team environment
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• 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:
• Day shift
• Remote
• Great benefits effective day 1!
• Competitive pay
• Mission driven team environment
Apply tot his job
Apply To this Job