Credentialing Manager | ABA

As the leader of our Credentialing Department, you will supervise and manage daily operations, focusing on workflow distribution, prioritization, and employee development.

Responsibilities

Supervise and manage daily operations of the Credentialing Department, including workflow distribution, prioritization, and employee development; Monitor application statuses, processing timelines, and department work queues to identify and resolve delays or barriers; Serve as the primary escalation point for complex credentialing, enrollment, contracting, and payer-related issues; Drive team success through continuous training, performance management, and quality assurance initiatives; Oversee credentialing, recredentialing, enrollment, and provider maintenance to ensure compliance with payer, regulatory, and organizational requirements; Ensure provider licenses, certifications, NPI records, and CAQH profiles remain current; Manage departmental databases and tracking tools and conduct regular audits of provider files; Develop and maintain the department's SOPs and policies; Build and maintain relationships with payer representatives and regulatory agencies; Partner with Operations, Recruiting, HR, and Clinical Leadership to support provider onboarding and location roster maintenance; Participate in strategic planning related to market expansion, contract development, and research of new funding sources; Track key department metrics, prepare reports for leadership, and lead continuous process improvement initiatives; Take on special projects and additional duties as assigned

Requirements

3–5 years of healthcare credentialing, provider enrollment, contracting, or related experience; Experience with CAQH, NPPES, PECOS, payer portals, and credentialing databases; Strong organizational, analytical, problem-solving, and project management skills; Ability to manage multiple priorities, meet deadlines, and collaborate effectively across departments

Nice to have

Bachelor's degree in Healthcare Administration, Business Administration, Healthcare Management, or a related field; Previous supervisory, lead, or management experience; Multi-state credentialing and provider enrollment experience; Experience with commercial insurance plans, Medicaid, Medicare, Tricare, and other funding sources

Benefits

Competitive pay with optional On-Demand paychecks through DailyPay; 401K Plan with company match after 6 months of employment; Paid Personal Time Off; Paid Holidays; Medical, Dental and Vision Insurance; Performance and promotion raises; Free 24/7 telehealth access to a doctor for you and your dependents with no limits and no co-pays; Free telehealth mental health counseling for you and your dependents (over age 13) with no limits or co-pays; Employee Assistance Program with free access to support services (financial, legal, counseling, etc.); Discounted monthly gym membership to 12,000 gym locations nationwide and free access to workout videos; Exclusive discounts and savings to 500+ companies; Travel discounts on hotels, rental cars, flights, excursions and more; 10-80% off routine lab work; 10-80% off prescription medications at 60,000+ locations nationwide