Senior Manager, Credentialing & Enrollment
Skills
- Deep knowledge of provider licensure and Medicaid enrollment processes across multiple states
- Experience with credentialing platforms and provider data management
- Strong operational leadership and team management
- Excellent written and verbal communication with stakeholders at all levels
- Attention to detail and strong organizational skills
Responsibilities
- Manage team members who process provider licensure, Medicaid enrollment, and health plan credentialing for multi-specialty providers.
- Supervise day-to-day management of enrollment applications, primary source verifications, provider expirables, and credentialing file preparation.
- Administer the credentialing program, including delegated credentialing, Credentialing Committee facilitation, and policy execution.
- Configure and maintain the credentialing platform (provider data accuracy, reporting, task management, committee administration).
- Liaise with state licensure boards, Medicaid agencies, and payer credentialing teams to resolve application issues and deficiencies.
- Monitor SLAs, milestones, and deadlines; analyze and report on application status and trends.
- Develop policies, cross-functional workflows, and training materials for team and providers.
Education
- High school diploma or equivalent required
- Bachelor's degree preferred but not required
- CPCS or CPMSM certification highly preferred or working toward certification
Benefits
- Base salary $110,000 - $130,000 plus annual bonus incentive
- Competitive medical, dental, and vision insurance
- Healthcare and Dependent Care FSA; company-funded HSA
- 401(k) with 4% match, 100% vested from day one
- Employer-paid short and long-term disability; life insurance at 1x salary
- 20 days PTO, 10 company holidays, and 2 floating holidays
- Paid new parent leave; employee equity purchase program eligibility
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