Credentialing & Enrollment Manager

Job Summary: The Manager will oversee the verification of provider qualifications and manage their enrollment with commercial and government payors. The Manager will lead and grow the centralized team, maintain accurate databases, manage re-credentialing, and act as subject matter expert on state and federal regulations. The Manager will be an effective communicator, partnering with departmental leaders, providers, and offices and managers in the field. The Manager will align and actively participate in the company’s strategic quarterly and annual goals, holding team members accountable for their role in the goals.

Supervisory Responsibilities:

• Supervises Credentialing Coordinators and Credentialing Specialists
• Conducts training, coaching, and performance evaluations

Essential Duties / Responsibilities:

• Manage end-to-end credentialing, re-credentialing, payor enrollment, and privileging for all providers.
• Ensure adherence to state, federal, and accreditation standards (e.g., NCQA, Joint Commission) and conduct internal audits.
• Maintain updated provider records, including DEA licenses, board certifications, and Malpractice insurance, within internal systems and portals like CAQH.
• Supervise and develop credentialing staff, manage performance, set priorities, and oversee external vendors.
• Build relationships with payor representatives to accelerate enrollment cycles and resolve issues. 
• Reduce provider enrollment turnaround time.
• Ensure any compliance audit findings are remedied immediately, and root cause performed to mitigate recurrence.
• Act as the liaison and facilitator for the department, effectively communicating with the Vice President of Revenue Cycle and other key departmental leaders
• Responsible for departmental documentation, including but not limited to job aides, SOPs, policies, and quick reference guides.
• Responsible for continuous process improvement and system automations as relates to departmental roles and functions.
• Act as backup for team members when they are out of office, or when inventory warrants “rolling up your sleeves” to help ensure all timelines and dependencies are met.
• Other duties as assigned.

Required Skills / Abilities: 

• Compliance with all HIPAA policies
• Microsoft Office experience (Excel, Word, Outlook, PowerPoint)
• Excellent organization and communication skills
• Handle multiple projects simultaneously in a fast-paced environment
• Satisfactory criminal background check

Education and Experience: 

• Associate’s degree, bachelor’s degree preferred.
• 5+ years in the healthcare industry

*StrideCare is an Equal Opportunity Employer and is committed to diversity and inclusion in our workforce. We encourage applications from candidates of all backgrounds and experiences.

• Ability to sit for extended periods while working at a computer.
• Manual dexterity required for operating office equipment (e.g., computers, phones, fax machines).
• Ability to lift and carry up to 20 pounds occasionally.
• Visual acuity is required to perform tasks involving computer screens and paper documents.
• Ability to move around the office to access files, office machinery, and other equipment.