Payer Credentialing Manager

Theoria Medical

Payer Credentialing Manager responsible for overseeing payer credentialing processes for healthcare providers. Ensuring compliance with regulations and managing the credentialing team remotely.

Posted 7/23/2026full-timeRemote • Missouri • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Expertise in payer credentialing processes and compliance with national accreditation standards, combined with strong supervisory skills to manage teams and ensure quality outcomes in healthcare administration.

Highest-signal resume keywords

Payer CredentialingPayer Enrollment ProcessesSupervisory ExperienceHealthcare AdministrationRegulatory Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer Credentialing SystemsDatabase ManagementMicrosoft ExcelMicrosoft AccessMicrosoft Word

Soft Skills

Organizational SkillsAttention to DetailCommunicationProblem-Solving

Tools & Technologies

CAQHMedallion

Industry Keywords

Healthcare AdministrationAccreditation StandardsState RegulationsFederal Regulations

About the role

Key responsibilities & impact

Oversee the processing of initial payer applications for health professionals, ensuring compliance with national accreditation standards and state/federal regulations.
Maintain and manage payer credentialing databases and electronic records, ensuring accuracy, confidentiality, and audit readiness.
Liaison with medical staff leadership, payers, licensure boards, and regulatory agencies to resolve credentialing issues promptly.
Supervise payer credentialing staff by coordinating workloads, providing training, monitoring performance, and ensuring quality outcomes.
Conduct regular audits of payer credentialing processes to identify gaps, implement corrective actions, and drive continuous improvement.

Requirements

What you’ll need

Bachelor’s degree in healthcare administration, business, or related field.
Minimum of 3 years in payer credentialing or healthcare administration.
1–3 years in a supervisory or managerial role.
Demonstrated experience with payer enrollment processes.
Hands-on experience with payer credentialing systems (e.g., CAQH, Medallion).
Strong knowledge of databases and Microsoft Office applications (Excel, Access, Word).
Strong organizational skills, attention to detail, communication, problem-solving, and knowledge of regulatory guidelines.

Benefits

Comp & perks

Competitive salary
401(k) with employer match
Health, dental, and vision insurance
PTO + paid holidays
Life insurance coverage
Remote flexibility with a national legal scope