Credentialing Manager (Remote)

PsychoGeriatric Services

11d • $70,000 • Remote

About The Position

The Credentialing Manager is responsible for overseeing and coordinating the credentialing and payer enrollment processes that support provider participation across the organization. This role manages clinician enrollment with government and commercial payers, including Medicare, Medicaid, CareFirst BlueCross BlueShield, Aetna, UnitedHealthcare, Cigna, Optum, Kaiser, Humana, TRICARE, and other payer partners. The primary objective of this position is to ensure accurate provider data management and compliance with regulatory, accreditation, legal, and organizational requirements while supporting timely provider onboarding and uninterrupted access to patient care.

Requirements

• 5+ years of credentialing experience required.
• Experience using credentialing software.
• Experience in having direct reports and managing external vendors.
• Bachelor’s degree in healthcare or related field preferred.
• Strong understanding of HIPAA and healthcare documentation compliance standards.
• Proven ability to train and support staff with varying levels of technical proficiency

Nice To Haves

• Experience with payer contract negotiation is a plus.
• Experience with credentialing providers in a multi-specialty, mobile, behavioral health practices is preferred.
• Experience working with payers in Pennsylvania is preferred.

Responsibilities

• Manage provider credentialing, re-credentialing, and enrollment with assigned insurance payers, ensuring completion within established timelines and KPIs.
• Lead and oversee internal and external credentialing team members, holding vendors accountable to service level agreements (SLAs), KPIs, and quality standards.
• Track and report credentialing metrics; identify and implement process improvements to reduce turnaround time.
• Provide clear, timely communication to providers and internal stakeholders on credentialing status, requirements, and next steps.
• Review and maintain accurate provider files and system records, ensuring compliance with payer requirements, state regulations, and company policies.
• Resolve complex credentialing and provider file issues with accuracy and urgency.
• Coordinate contract execution and network participation once providers are approved.
• Collaborate with RCM and other internal teams to resolve credentialing-related issues impacting revenue cycle.
• Prepare and present weekly updates on credentialing progress, vendor performance, and KPIs.
• Effectively manage workload, priorities, and time across team assignments

Benefits

• Have a direct impact on improving access to behavioral health services for vulnerable, underserved patients.
• Leave your mark on a growing, mission-driven company.
• Up to 100% company-paid healthcare, dental, and vision insurance.
• All employees enjoy paid time off (vacation, holiday, and sick leave).
• Access to a 401(k) plan with generous company matching.
• Access to a Health Savings Account (HSA) and/or dependent care FSA (DCFSA).

What This Job Offers

• Job Type: Full-time
• Career Level: Manager