Credentialing Manager

Position Summary

The Credentialing Manager is responsible for leading and executing all aspects of provider credentialing, payer enrollment, and payer contracting. This role serves as both a strategic leader and a hands-on contributor, ensuring credentialing operations are efficient, compliant, and aligned with provider onboarding timelines.

The ideal candidate brings prior experience as a credentialing lead or manager and has deep expertise in resolving complex enrollment and contracting issues, driving timelines, and supporting organizational growth.

Key Responsibilities

Leadership & Execution
• Lead, mentor, and support the credentialing team while maintaining a hands-on role in daily operations
• Act as a working manager, stepping in to complete credentialing, enrollment, and contracting tasks as needed
• Set clear expectations, monitor performance, and ensure accountability to timelines

Credentialing & Payer Enrollment
• Oversee and actively manage end-to-end provider credentialing and recredentialing processes
• Lead payer enrollment activities including initial enrollments, revalidations, updates, and terminations
• Ensure compliance with all payer, state, and federal requirements

Payer Contracting
• Manage and support payer contracting processes, including applications, follow-up, and execution
• Track and drive contract timelines to ensure providers are in-network as quickly as possible
• Partner with leadership on payer participation and network strategy

Strategy, Timelines & Process Improvement
• Develop and manage credentialing and enrollment timelines aligned with provider start dates
• Identify bottlenecks and implement process improvements to increase efficiency and reduce delays
• Build tracking and reporting mechanisms to provide visibility into credentialing status and risks

Problem-Solving & Escalations
• Serve as the escalation point for complex or stalled credentialing, enrollment, or contracting issues
• Proactively identify risks and implement solutions to prevent delays
• Build and leverage payer relationships to resolve issues effectively

Qualifications

Required
• 5+ years of credentialing experience, including experience 2+ years in a supervisory or management role.
• Direct experience with payer enrollment and payer contracting
• Strong working knowledge of credentialing processes, compliance requirements, and payer systems
• Demonstrated ability to manage timelines and resolve complex credentialing and enrollment issues
• Experience leading or mentoring team members

Preferred
• Experience credentialing providers in Minnesota, South Dakota, and Wisconsin
• Multi-state credentialing experience
• Experience in a high-growth or multi-site healthcare organization
• Familiarity with CAQH and credentialing/enrollment platforms

Key Competencies
• Hands-on, roll-up-your-sleeves leadership approach
• Strong problem-solving and critical thinking skills
• Ability to manage competing priorities and tight timelines
• High attention to detail and accuracy
• Effective cross-functional communication

Success Measures
• Providers credentialed and enrolled in alignment with start dates
• Reduction in enrollment and contracting delays
• Efficient resolution of payer issues and escalations
• Accurate, compliant credentialing records
• Strong team performance and accountability

EEO Statement:

The Remedy Mental Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, or any other protected status.

Disclaimer:

This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the position. Duties may change based on business needs.

Work Authorization Requirement:
All candidates must be legally authorized to work in the United States. The company does not currently sponsor employment visas.