Credentialing Manager
Fay
full-time
Posted on:
Location Type: Remote
Location: California • New York • United States
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About the role
- Own a dedicated portfolio of 10–15 payers end-to-end.
- Manage a team of Provider Enrollment Specialists responsible for application execution.
- Audit existing credentialing workflows and implement scalable improvements — including technology enablement, process redesign, and smarter resource allocation.
- Define and own SLAs across the credentialing lifecycle.
- Design the credentialing workflows required to operationalize net-new payer contract relationships and lead internal launch.
Requirements
- 3+ years of hands-on provider credentialing and enrollment experience, with at least 2 years in a lead or management capacity — ideally at a health plan, MSO, delegated credentialing entity, or high-growth digital health company
- Deep working knowledge of CAQH ProView, NPDB queries, state licensing and scope-of-practice databases, and the enrollment portals of major commercial and government payers (e.g., Aetna, BCBS, Cigna, UHC, Humana, Medicare/Medicaid)
- Demonstrated experience redesigning credentialing workflows — not just executing them — across a high volume of providers and multiple national payers simultaneously
- Experience owning credentialing KPIs and building payer health dashboards with SLA tracking and escalation management
- Strong understanding of the downstream impact of credentialing on claims, billing, and revenue cycle — and how to coordinate across those functions
- Comfortable operating in fast-moving environments where processes are still being built and priorities can shift quickly.
- Preferred: Experience credentialing allied health or telehealth providers — particularly dietitians, therapists, or other non-physician specialties
- Familiarity with delegated credentialing agreements and the operational implications of delegated vs. non-delegated payer relationships
- Background at a high-growth startup or digital health company
- Tech-savvy with a strong appetite for automation and systems that enhance speed, accuracy, and scalability.
Benefits
- Health insurance
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
provider credentialingprovider enrollmentcredentialing workflowscredentialing KPIspayer health dashboardsCAQH ProViewNPDB queriesstate licensingscope-of-practice databasesdelegated credentialing
Soft Skills
leadershipteam managementprocess redesignresource allocationadaptabilitycommunicationproblem-solvingoperational efficiencycollaborationstrategic thinking