Credentialing & Enrollment Manager at Jobgether – United States

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Credentialing & Enrollment Manager in United States.

This role is responsible for managing all aspects of provider credentialing, enrollment, and licensure across multiple states and healthcare networks. You will ensure that clinical staff are fully authorized to provide care by maintaining compliance with federal, state, and payer requirements. The position oversees relationships with commercial payers, Medicaid, Medicare, hospital partners, and regulatory bodies, driving timely and accurate credentialing processes. You will develop and refine workflows, implement tools to streamline operations, and report on credentialing status and compliance risks to leadership. This is an impactful role with high visibility, combining operational oversight, process development, and stakeholder management in a collaborative, patient-focused environment. Ideal candidates thrive in healthcare administration, are detail-oriented, and can navigate complex multi-state compliance requirements.

• Manage all provider credentialing and re-credentialing activities with commercial payers, Medicaid, and Medicare, ensuring timely submission and updates
• Oversee hospital and facility credentialing for inpatient consult service lines and support team members needing hospital privileges
• Track and manage provider licensure across multiple states, supporting new license acquisition as organizational footprint expands
• Develop, maintain, and enforce standardized credentialing policies, procedures, and workflows
• Implement and manage credentialing systems (CAQH, portals, or software tools) to streamline operations
• Maintain credentialing files in compliance with NCQA, URAC, and other regulatory standards
• Generate regular reports for leadership on credentialing status, expiration dates, and compliance risks
• Serve as a liaison between internal leadership, clinical providers, health plans, and credentialing bodies

• 3–5+ years of experience in provider credentialing and enrollment with commercial and government payers
• Strong understanding of healthcare compliance, payer requirements, and credentialing standards
• Familiarity with CAQH and payer portals for enrollments and provider updates
• Experience managing provider licensure and DEA registrations across multiple states
• Excellent attention to detail, organizational skills, and ability to manage multiple priorities
• Strong written and verbal communication skills to effectively engage internal and external stakeholders
• Preferred: experience with behavioral health credentialing, hospital privileging processes, multi-state organizations, and CPCS or CPMSM certification

• Healthcare Coverage: Medical, dental, and vision insurance with 60% premium contribution
• Flexible Time Off: Generous PTO, floating paid holidays, and paid volunteer days
• Re-Fuel Days: 4 additional paid days off per year for mental health, rest, or continuing education
• Employee Assistance Program (EAP): Free access to therapy, legal guidance, financial resources, health coaching, and more
• 401(k) with up to 5% employer match
• 100% employer-paid short- and long-term disability and life insurance
• Additional perks: Rightway Health Concierge, PerkSpot discounts, SoFi student loan discount, and one year of free pet telehealth
• Opportunity to shape processes and impact growth at the ground level