Credentialing Manager

Charlie Health

Credentialing Manager leading Charlie Health’s credentialing and provider enrollment program. Overseeing a team and managing delegated credentialing, payor audits, and compliance activities.

Posted 6/10/2026full-timeRemote • Alaska, California, Colorado, Connecticut, Maine, Massachusetts, Minnesota, New Jersey, New York, Oregon, Washington • 🇺🇸 United StatesMid-LevelSenior💰 $70,000 - $77,500 per yearWebsite

Tech Stack

Tools & technologies

Cloud

About the role

Key responsibilities & impact

Lead, manage, and develop a team of 5+ credentialing specialists, owning team KPIs including enrollment turnaround times and applications submitted & approved
Own and operate the delegated credentialing program end-to-end, including provider onboarding, primary source verification, and maintaining NCQA-aligned standards
Lead the internal credentialing committee — presenting cases, maintaining meeting minutes, and managing approvals
Manage required payor audits and internal audits to ensure ongoing NCQA and delegated credentialing compliance
Set and drive long-term credentialing strategy, partnering with Commercial Strategy to expand delegated credentialing statuses across payors
Build and maintain a centralized “Credentialing Source of Truth” documenting payor-specific requirements (provisional credentialing, SLAs, backdating policies, etc.)
Partner with RevOps to align on KPIs and incentive structure, and with RCM to troubleshoot problem payors and credentialing-related denials
Identify and implement process improvements that increase team efficiency, including automation and AI-enabled workflows
Oversee day-to-day payor and Medicaid enrollment across group and individual submissions, ensuring timely, accurate, and compliant applications tracked in Salesforce

Requirements

What you’ll need

Bachelor’s degree
5+ years of experience in provider credentialing and/or health plan enrollment
Direct, hands-on experience owning or operating a delegated credentialing program is required, including primary source verification, credentialing committee operations, and NCQA standards
2+ years of people management experience leading a credentialing or enrollment team preferred
Experience with both Medicaid and Commercial payor enrollment
Comfort with process improvement and a track record of leveraging automation and emerging technologies (including AI) to streamline operations
Strong cross-functional collaboration skills across RevOps, RCM, Commercial Strategy, and Compliance
Work authorized in the United States and native or bilingual English proficiency
Familiarity with and willingness to use cloud-based communication software — Google Suite, Slack, Zoom, Dropbox, Salesforce

Benefits

Comp & perks

comprehensive benefits to all full-time, exempt employees

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

provider credentialingprimary source verificationNCQA standardsdelegated credentialing programpayor auditsprocess improvementautomationAI-enabled workflowsMedicaid enrollmentCommercial payor enrollment

Soft Skills

team managementcross-functional collaborationstrategic planningproblem-solvingcommunicationleadershiporganizational skillspresentation skillsefficiency improvementKPI management

Certifications

Bachelor's degree