Director of Credentialing Management (US Health Insurance)

Wellnite; India; A distancia; INR 14.354.000 - 20.096.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive salary based on experience

Fully remote work

High-impact leadership role

Competitive salary

Descripción de la vacante

A modern mental health platform is seeking a Director of Credentialing Management to enhance provider credentialing and payer enrollment operations. This role involves leading a team, negotiating with payers like BCBS and UnitedHealthcare, and streamlining credentialing processes. The ideal candidate should have over 5 years of relevant experience and a strong understanding of payer relations. This position is fully remote, offering competitive compensation based on experience, and is crucial for our growth in the healthcare market.

Formación

• 5+ years of credentialing and payer enrollment experience.
• Proven experience managing and leading credentialing teams.
• Hands-on experience enrolling providers with major payers.
• Strong EFT enrollment and payer setup knowledge.
• Experience negotiating with payer representatives.
• Deep knowledge of provider onboarding and enrollment workflows.

Responsabilidades

• Lead provider credentialing and enrollment operations.
• Negotiate enrollment terms with payers.
• Manage and mentor a credentialing team.
• Ensure providers appear correctly in payer directories.
• Negotiate enrollment terms and resolve issues with payers.
• Build and mentor credentialing team; set KPIs.
• Improve turnaround times and reduce backlog.
• Collaborate with Billing, Provider Ops and Engineering.
• Maintain compliance with state and federal requirements.

Conocimientos

Credentialing experience

Team management

Enrollment negotiation

EFT enrollment knowledge

Provider onboarding workflows

Descripción del empleo

Director of Credentialing Management (US Health Insurance)

Company: Wellnite

Location: Remote (U.S. time zones preferred)

About Wellnite

Wellnite is a modern mental health platform connecting patients with licensed providers across the United States. We work with major commercial payers and are scaling quickly. Credentialing accuracy, speed, and payer relationships are critical to our growth—this role owns that function end-to-end.

Role Overview

We are seeking a Director of Credentialing Management to lead and scale our provider credentialing and payer enrollment operations. This is a hands‑on leadership role responsible for payer negotiations, team management, enrollment execution, and continuous process improvement across multiple insurance networks.

You will directly impact revenue, provider activation speed, and patient access.

Key Responsibilities

Credentialing & Enrollment Leadership

• Own end-to-end provider credentialing and recredentialing workflows
• Manage enrollments with major payers including BCBS, Optum, UnitedHealthcare, and other commercial plans
• Oversee EFT enrollment and payer setup to ensure clean claims and timely reimbursement
• Ensure providers are accurately reflected in payer directories

Payer Relations & Negotiation

• Act as primary point of contact for payer credentialing teams
• Negotiate enrollment terms, timelines, and issue resolution with payers
• Escalate and resolve stalled or denied applications efficiently

Team Management

• Build, manage, and mentor a credentialing team
• Set clear KPIs, workflows, and accountability standards
• Train team members on payer‑specific requirements and best practices

Operational Excellence

• Reduce credentialing turnaround time and backlog aging
• Identify bottlenecks and implement scalable process improvements
• Partner closely with Billing, Provider Ops, and Engineering teams
• Maintain compliance with state and federal requirements

Required Qualifications

• 5+ years of credentialing and payer enrollment experience
• Proven experience managing and leading credentialing teams
• Hands‑on experience enrolling providers with BCBS, Optum, UnitedHealthcare
• Strong understanding of EFT enrollment and payer setup
• Experience negotiating directly with payer representatives
• Deep knowledge of provider onboarding and enrollment workflows

to Have

• Experience with mental health / behavioral health credentialing
• Familiarity with multi‑state provider networks
• Experience scaling credentialing operations in a fast‑growing company

What Success Looks Like

• Providers go live faster with fewer enrollment errors
• Credentialing backlog is controlled and predictable
• Strong payer relationships with fewer escalations
• Credentialing team operates with clarity, speed, and accountability

Why Join Wellnite

• High‑impact leadership role with executive visibility
• Opportunity to shape and scale a critical operational function
• Competitive salary based on experience
• Fully remote, U.S. work hours