Credentialing Manager

Integrated Services of Appalachian Ohio

Credentialing Manager overseeing provider credentialing and payer enrollment for Integrated Services for Behavioral Health. Managing the credentialing team and ensuring compliance with various requirements.

Posted 6/19/2026full-timeRemote • Ohio, Washington • 🇺🇸 United StatesMid-LevelSenior💰 $87,000 - $108,000 per yearWebsite

About the role

Key responsibilities & impact

Oversee all provider credentialing, recredentialing, payer enrollment, and provider maintenance activities for ISBH
Manage the credentialing team and coordinate daily workflow to ensure the timely completion of credentialing activities
Responsible for performance management, recruitment, onboarding, and team development, including but not limited to implementing progressive discipline when necessary
Ensure timely submission, tracking, and follow-up of credentialing and recredentialing applications to prevent lapses in provider participation
Maintain provider credentialing files and databases, ensuring all licenses, certifications, registrations, and other required documentation remain current.
Monitor provider enrollment status with Ohio Medicaid, Medicare, commercial payers, and other contracted entities
Serve as the primary resource for resolving complex credentialing and payer enrollment issues
Ensure compliance with federal, state, accreditation, and payer-specific credentialing requirements
Develop, implement, and maintain credentialing policies, procedures, and quality assurance standards
Monitor credentialing performance metrics and identify opportunities for process improvement and operational efficiency
Collaborate with billing, compliance, human resources, clinical leadership, and provider relations teams to support organizational goals
Maintain expertise in credentialing regulations, payer requirements, provider enrollment processes, and industry best practices
Coordinate credentialing activities related to new programs, services, locations, and revenue streams
Participate in audits, accreditation reviews, and compliance activities as required
Attend virtual and in-person internal and external training, conferences, and meetings as appropriate
Maintain compliance with HIPAA, mandated reporting requirements, and professional ethical guidelines
Travel within the designated service area
Perform other duties as assigned

Requirements

What you’ll need

A high school diploma or GED equivalent is required
A bachelors degree in business, Public Health, Healthcare Administration, or a related field is preferred
5 years of experience in provider credentialing and payer enrollment in a healthcare setting is required
3 years of supervisory or management experience in a healthcare credentialing role is required
Experience with Ohio Medicaid provider enrollment and credentialing is required
Experience working with credentialing systems and electronic health records is required
Experience utilizing NPPES, CAQH, Ohio Medicaid PNM, and payer enrollment portals is required
Knowledge of credentialing standards, provider enrollment requirements, and healthcare regulatory compliance
Ability to manage multiple projects, deadlines, and priorities independently
Advanced analytical, organizational, and problem-solving skills
Proficiency with databases, spreadsheets, and Microsoft Office applications
Advanced communication skills, both oral and written is required
Advanced organizational skills are required
Knowledge of local, state, and federal regulations is required
The ability to maintain confidential information is required
Ability to adhere to all safety rules, regulations, and requirements
A valid driver's license and the ability to operate a motor vehicle are required
An appropriate level of auto insurance coverage is required
Ability to manage deadlines within a fast-paced, high-volume environment is required
The ability to operate in an Internet-based, automated office environment is required
The ability to maintain a high-speed internet connection is required.

Benefits

Comp & perks

Medical
Dental
Vision
Short-term Disability
Long-term Disability
401K w/ Employer Match
Employee Assistance Program (EAP) provides support and resources to help you and your family with a range of issues.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

provider credentialingpayer enrollmentcredentialing systemselectronic health recordsNPPESCAQHOhio Medicaid PNMcredentialing standardshealthcare regulatory compliancedata analysis

Soft Skills

performance managementteam developmentproblem-solvingorganizational skillscommunication skillsproject managementindependent workconfidentialitytime managementadaptability