Credentialing & Contracting Manager

NIVA Health; India; Vor Ort; INR 1.400.000 - 2.200.000; Vollzeit

Zusammenfassung

NIVA Health is seeking an experienced credentialing leader to own the provider lifecycle, from accepted offer to ready-to-care status and ongoing maintenance. You will coordinate contracting, payer enrollment, and offboarding with a focus on accuracy and scalability.

You will partner with HR, Clinical Operations, Revenue Cycle, Billing, Compliance, Legal, and Leadership to drive KPIs, dashboards, and process improvements that ensure timely provider readiness and compliant enrollments across

Qualifikationen

• 5+ years of progressive experience in provider credentialing, payer enrollment, provider contracting, or healthcare operations.
• Strong working knowledge of Medicare, Medicaid, and commercial payer enrollment.
• Experience with provider credentialing and contracting, including collaborative practice agreements.
• Experience managing multiple provider onboarding and credentialing projects simultaneously.
• Experience managing or holding a third-party credentialing vendor accountable.
• Strong organizational and project management skills—you know how to manage a lot of moving pieces without losing track of the details.
• Advanced Microsoft Excel and reporting skills.
• Experience working with provider databases and credentialing software.
• Excellent written and verbal communication skills.
• A bachelor's degree in Healthcare Administration, Business Administration, Human Resources, or a related field is preferred.

Aufgaben

• Own the credentialing process from accepted offer through provider readiness and ongoing maintenance.
• Manage and hold our third-party credentialing vendor accountable for timelines, quality, service levels, and results.
• Establish credentialing priorities based on provider start dates, patient access, business growth, geographic expansion, and payer requirements.
• Lead regular status reviews, identify barriers and delays, and elevate risks that could impact provider start dates or patient care.
• Oversee provider contracting, including employment, independent contractor, collaborative practice, supervising physician, medical director, telehealth, delegation, and related agreements.
• Ensure provider contracts are executed before patient care begins and maintain renewal and expiration schedules.
• Oversee Medicare, Medicaid, and commercial payer enrollment and maintain accurate enrollment reporting.
• Partner with Revenue Cycle and Billing to resolve enrollment-related issues that affect claims and reimbursement.
• Own provider lifecycle maintenance, including licenses, certifications, DEA registrations, malpractice coverage, collaborative agreements, practice locations, supervising physicians, and state expansions.
• Lead the credentialing and contracting side of provider offboarding, ensuring payer notifications, contract terminations, and system updates happen accurately and on time.
• Maintain complete, current, audit-ready provider files.
• Develop KPIs, dashboards, SOPs, and reporting that give leadership clear visibility into credentialing performance.
• Identify opportunities for automation, process improvement, and standardization.
• Serve as NIVA Health’s subject matter expert on provider credentialing operations.
• Partner closely with HR, Clinical Operations, Revenue Cycle, Billing, Finance, Compliance, Legal, and Executive Leadership.

Kenntnisse

Provider credentialing

Payer enrollment

Provider contracting

Vendor management

Project management

Microsoft Excel

Healthcare operations

Communication skills

Ausbildung

Bachelor's in Healthcare Admin

Tools

Credentialing software

Provider databases

Payer enrollment systems

Jobbeschreibung

Own the process that gets our providers ready to care for patients.

If you’re an experienced healthcare credentialing professional who knows how to turn a complicated credentialing process into something organized, predictable, and accountable, this could be the role for you.

At NIVA Health, credentialing isn’t simply paperwork—it directly impacts when our providers can start seeing patients and how quickly we can grow into new markets. We’re looking for someone who can take ownership of the entire provider lifecycle, from accepted offer through credentialing, contracting, payer enrollment, ongoing maintenance, and ultimately separation.

You’ll be the person who knows where every provider stands, what’s holding things up, who needs to take action, and what needs to happen next.

What you’ll own

You’ll lead NIVA Health’s provider credentialing, contracting, payer enrollment, and provider lifecycle processes, while continuously looking for ways to make them more efficient and scalable.

Your responsibilities will include:

• Own the credentialing process from accepted offer through provider readiness and ongoing maintenance.
• Manage and hold our third-party credentialing vendor accountable for timelines, quality, service levels, and results.
• Establish credentialing priorities based on provider start dates, patient access, business growth, geographic expansion, and payer requirements.
• Lead regular status reviews, identify barriers and delays, and elevate risks that could impact provider start dates or patient care.
• Oversee provider contracting, including employment, independent contractor, collaborative practice, supervising physician, medical director, telehealth, delegation, and related agreements.
• Ensure provider contracts are executed before patient care begins and maintain renewal and expiration schedules.
• Oversee Medicare, Medicaid, and commercial payer enrollment and maintain accurate enrollment reporting.
• Partner with Revenue Cycle and Billing to resolve enrollment-related issues that affect claims and reimbursement.
• Own provider lifecycle maintenance, including licenses, certifications, DEA registrations, malpractice coverage, collaborative agreements, practice locations, supervising physicians, and state expansions.
• Lead the credentialing and contracting side of provider offboarding, ensuring payer notifications, contract terminations, and system updates happen accurately and on time.
• Maintain complete, current, audit-ready provider files.
• Develop KPIs, dashboards, SOPs, and reporting that give leadership clear visibility into credentialing performance.
• Identify opportunities for automation, process improvement, and standardization.
• Serve as NIVA Health’s subject matter expert on provider credentialing operations.
• Partner closely with HR, Clinical Operations, Revenue Cycle, Billing, Finance, Compliance, Legal, and Executive Leadership.

What we’re looking for

You’re likely a strong fit if you have:

• 5+ years of progressive experience in provider credentialing, payer enrollment, provider contracting, or healthcare operations.
• Strong working knowledge of Medicare, Medicaid, and commercial payer enrollment.
• Experience with provider credentialing and contracting, including collaborative practice agreements.
• Experience managing multiple provider onboarding and credentialing projects simultaneously.
• Experience managing or holding a third-party credentialing vendor accountable.
• Strong organizational and project management skills—you know how to manage a lot of moving pieces without losing track of the details.
• Advanced Microsoft Excel and reporting skills.
• Experience working with provider databases and credentialing software.
• Excellent written and verbal communication skills.
• A bachelor's degree in Healthcare Administration, Business Administration, Human Resources, or a related field is preferred.

The person who will thrive here

You’re not someone who waits for a problem to land on your desk.

You naturally create structure. You follow up. You spot bottlenecks before they become problems. You’re comfortable holding vendors and internal stakeholders accountable, and you know how to elevate an issue when it could affect a provider's start date or patient access.

You can zoom into the details of a payer enrollment issue one minute and then step back and give leadership a clear picture of the overall credentialing pipeline the next.

Most importantly, you understand that credentialing is an operational function, not just an administrative one.

Why this role matters

NIVA Health is growing, and provider readiness is critical to that growth. This role sits at the intersection of our clinical operations, revenue cycle, HR, legal, finance, and leadership teams.

You’ll have the opportunity to build and continuously improve the processes that allow our providers to get credentialed, contracted, enrolled, and ready to care for patients—while creating the visibility and accountability needed to scale.

If you’re ready to take ownership of a credentialing function rather than simply work within one, we’d love to hear from you.

About NIVA Health

NIVA Health is committed to providing exceptional healthcare while continuing to grow and innovate. We believe strong teams, operational excellence, and a focus on patient care are essential to that mission.

NIVA Health is an Equal Opportunity Employer. We are committed to creating an inclusive workplace free from discrimination and harassment. All qualified applicants will receive consideration regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic.

Reasonable accommodations are available throughout the application and interview process.