Credentialing / Enrollment Lead

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Credentialing / Enrollment Lead based in the United States.

This role is responsible for leading critical credentialing and enrollment operations that enable a rapidly growing healthcare provider network.
You will translate strategy into clear operating plans while overseeing teams and virtual-assistant capacity supporting day-to-day workflows.
The role combines people leadership, complex program ownership, operational rigor, and continuous process improvement.
You will help ensure payer enrollments, provider credentialing, monitoring, and delegated arrangements scale without becoming a barrier to growth.
Your work will directly influence provider onboarding, compliance, operational quality, and the overall provider experience.
You’ll operate cross-functionally with Product, Engineering, Payer Operations, Finance, Revenue Cycle Management, Clinical Operations, and Customer Experience teams.
This is an ideal opportunity for an experienced healthcare operations leader who thrives in ambiguity and enjoys building scalable systems in a high-growth environment.

Accountabilities

• Lead a pod of Credentialing or Enrollment Associates and Senior Associates by setting priorities, clarifying ownership, establishing deadlines, reviewing work quality, providing feedback, and holding team members accountable for outcomes.
• Direct virtual-assistant capacity supporting the team, including work allocation, training, quality assurance, and performance monitoring.
• Own complex credentialing and enrollment programs end to end, including payer enrollments, provider credentialing workflows, ongoing monitoring, and delegated credentialing operations.
• Support credentialing workflows for Medical Doctors, Nurse Practitioners, Therapists, Registered Dietitians, and other provider types as the network expands.
• Build and maintain clear SOPs, operating cadences, quality controls, documentation standards, escalation procedures, and audit-ready records.
• Use operational metrics to manage capacity, throughput, timeliness, quality, provider experience, and execution risk, identifying gaps early and implementing practical improvement plans.
• Investigate complex or ambiguous payer, provider, regulatory, and operational issues using data and primary sources, balancing speed, compliance, provider experience, business impact, and cost.
• Design scalable workflows and identify opportunities for improved tooling, automation, ownership structures, and operational efficiency.
• Partner with Product, Engineering, Payer Operations, Finance, Revenue Cycle Management, Clinical Operations, and Customer Experience teams to improve credentialing and enrollment infrastructure.
• Serve as the day-to-day escalation point for assigned operational areas, independently resolving blockers and escalating material risks with clear recommendations.
• Communicate decisions, responsibilities, deadlines, risks, and next steps clearly to team members, leadership, providers, payers, and cross-functional stakeholders.
• Coach and develop associates into stronger operational owners and future leaders while maintaining reliable execution against team goals.

Requirements

• Approximately 5–9 years of experience in payer enrollment, credentialing, provider operations, healthcare operations, or a closely related field.
• Meaningful expertise across credentialing and enrollment processes, including payer enrollment, provider onboarding, ongoing monitoring, delegated credentialing, accreditation, or related workflows.
• Experience supporting credentialing or enrollment for Registered Dietitians and/or other healthcare provider types is highly relevant.
• Demonstrated people leadership experience, including setting priorities, directing work, providing constructive feedback, managing performance, and developing team members.
• Proven ability to own complex operational programs from planning through execution while maintaining high standards for quality, compliance, documentation, and deadlines.
• Strong analytical and operational management skills, with the ability to use metrics to monitor capacity, throughput, quality, timeliness, and execution risk.
• Excellent written and verbal communication skills, with the ability to simplify complex operational, regulatory, or payer-related topics for different audiences.
• Strong judgment and problem-solving abilities, particularly when investigating ambiguous issues and balancing competing priorities.
• Technology fluency and demonstrated experience improving operational processes through tooling, automation, workflow redesign, or collaboration with Product and Engineering teams.
• Highly organized, adaptable, and comfortable working in a rapidly changing healthcare environment.
• Ability to operate with ownership and independence while knowing when to escalate significant risks or decisions.
• Familiarity with NCQA requirements, delegated credentialing, payer requirements, and healthcare compliance processes is valuable.
• Experience in a startup or high-growth healthcare organization is a strong advantage.

Benefits

• Remote flexibility: Full-time opportunity open to fully remote candidates across the United States or candidates based in New York City.
• High-impact work: Directly contribute to scaling a healthcare provider network and improving access to care.
• Leadership opportunity: Manage and develop credentialing or enrollment professionals while building team capabilities and future leaders.
• Cross-functional exposure: Work closely with Product, Engineering, Payer Operations, Finance, Revenue Cycle Management, Clinical Operations, and Customer Experience teams.
• Growth environment: Take ownership of complex, ambiguous challenges and help build scalable processes during a period of rapid organizational growth.
• Operational innovation: Opportunity to improve workflows through automation, technology, data, and process redesign.
• Mission-driven culture: Work on initiatives designed to improve healthcare access, provider operations, and patient experiences.
• Competitive compensation and benefits: Comprehensive compensation and employee benefits are offered in line with the scope of the role, experience, and location.
• Professional development: Build expertise in healthcare credentialing, payer operations, people leadership, and scalable healthcare infrastructure.

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.