Credentialing & Payer Enrollments Lead

Salma Health, Inc.; San Mateo; Hybrid; PHP 5,109,000 - 6,386,000; Full time

Benefits offered by this job

Medical

Dental

Vision

PTO

Additional benefits

Job summary

Salma Health, Inc. is seeking a Credentialing Manager to lead provider credentialing, licensing, and re-credentialing, ensuring accurate records and compliant processes. The role blends hands-on operation with process development and vendor oversight.

Work is hybrid with in-office presence preferred in San Mateo on Mondays, Tuesdays, and Wednesdays; remote work may be considered for the right candidate based in eligible states. The position emphasizes audits, payer enrollment, and NCQA alignment.

Qualifications

• At least 3 years of experience in healthcare credentialing and payer enrollment.
• Working knowledge of NCQA credentialing standards, CMS enrollment requirements, and state licensing and Medicaid processes.
• Hands-on experience with CAQH, PECOS, NPPES, and payer enrollment portals.
• Strong organizational and project management skills, including handling multiple applications and deadlines.
• Working knowledge of health information management and privacy principles.
• Excellent written and verbal communication skills, including vendor and payer collaboration.

Responsibilities

• Manage the provider credentialing lifecycle, from onboarding and application review through approval and ongoing record maintenance.
• Keep provider and practice records current across CAQH, NPPES, PECOS, state Medicaid and commercial payer portals, and internal systems.
• Coordinate credentialing onboarding and offboarding steps with HR, clinical operations, and legal and compliance partners.
• Support the payer enrollment team with provider enrollment and revalidation for commercial payers, Medicare, Medicaid/Medi-Cal, managed care plans, and TRICARE.
• Maintain a provider-payer enrollment matrix that tracks application status, effective dates, delegated credentialing arrangements, and follow-up deadlines.
• Monitor expirations and renewals for licenses, DEA and state controlled substance registrations, board certifications and applicable facility credentials.
• Conduct recurring exclusion, sanction, and NPDB screenings, escalating findings promptly.
• Prepare for and respond to payer and delegated credentialing audits and accreditation reviews.
• Help maintain policies, procedures, and forms aligned with NCQA standards, state law, and payer requirements.
• Manage credentialing vendors and software, report on enrollment progress and risk areas, and serve as a point of contact for providers and internal partners on credentialing questions.

Skills

Healthcare credentialing

Payer enrollment

Project management

Organizational skills

Communication skills

Tools

CAQH

PECOS

NPPES

Job description

Salma Health, Inc. is seeking a Credentialing Manager to lead provider credentialing, licensing, and re-credentialing, ensuring accurate records and compliant processes. The role blends hands-on operation with process development and vendor oversight.

Work is hybrid with in-office presence preferred in San Mateo on Mondays, Tuesdays, and Wednesdays; remote work may be considered for the right candidate based in eligible states. The position emphasizes audits, payer enrollment, and NCQA alignment.