Credentialing & Enrollment Leader

Transcarent; Polska; Híbrido; PLN 473.000 - 709.000; Jornada completa

Descripción de la vacante

Transcarent is seeking a Manager, Credentialing & Enrollment to own credentialing and payer-enrollment operations for providers across all practitioner types. You will establish scalable processes, lead primary source verification, and ensure NCQA-compliant files while coordinating with licensing, clinic operations, and external vendors.

The role requires 5+ years in healthcare credentialing or related fields, plus strong leadership, communication, and analytical skills to drive audit-ready

Formación

• Bachelor’s degree in healthcare administration, nursing, business, public health, or related field.
• Five or more years in healthcare credentialing, payer enrollment, delegated credentialing, licensure, or related areas.
• Experience leading credentialing workflows and payer enrollment processes.
• Knowledge of NCQA credentialing standards and payer enrollment requirements.
• Ability to manage sensitive provider information and maintain secure, audit-ready records.
• Excellent written and verbal communication with cross-functional partners.
• Proficiency with spreadsheets, reporting tools, workflow systems, and credentialing platforms.

Responsabilidades

• Own credentialing and re-credentialing cycles across practitioner types with defined workflows and SLAs.
• Lead primary source verification and ensure NCQA-compliant provider files.
• Coordinate materials, resolve deficiencies, and communicate timelines clearly.
• Manage payer enrollment processes, including delegated enrollments and revalidations.
• Partner with licensing, clinic operations, and medical group operations for alignment with licensure and readines milestones.
• Lead audits, accreditation readiness, and data quality across credentialing and enrollment.
• Prepare reports and dashboards on status, milestones, and risks; escalate issues as needed.
• Provide cross-functional coverage for licensing when capacity is constrained.

Conocimientos

Attention to detail

Project coordination

Stakeholder management

Written and verbal communication

Problem solving

Educación

Bachelor's degree in healthcare administration or related field

Herramientas

CAQH

Verifiable

Salesforce

NCQA standards

Descripción del empleo

Transcarent is seeking a Manager, Credentialing & Enrollment to own credentialing and payer-enrollment operations for providers across all practitioner types. You will establish scalable processes, lead primary source verification, and ensure NCQA-compliant files while coordinating with licensing, clinic operations, and external vendors.

The role requires 5+ years in healthcare credentialing or related fields, plus strong leadership, communication, and analytical skills to drive audit-ready