Credentialing Manager

Charlie Health; Nashville (TN); On-site; USD 70,000 - 78,000; Full time

Job summary

Charlie Health in Nashville, Tennessee is seeking a Credentialing & Provider Enrollment Manager to lead our delegated credentialing function across Medicaid and Commercial payors. You will own the end-to-end process, including primary source verification, credentialing committee operations, and NCQA audits, while shaping the long-term strategy and guiding the team.

You will collaborate with Commercial Strategy, RevOps, RCM, and Compliance to expand delegated statuses, improve workflows with

Qualifications

• Bachelor's degree required.
• 5+ years of experience in provider credentialing and/or health plan enrollment.
• Direct, hands-on experience owning or operating a delegated credentialing program with primary source verification, credentialing committee operations, and NCQA standards.
• 2+ years of people management experience leading a credentialing or enrollment team.
• Experience with Medicaid and Commercial payor enrollment.
• Experience with automation and emerging technologies (including AI) to streamline operations.
• Strong cross-functional collaboration across RevOps, RCM, Commercial Strategy, and Compliance.
• US work authorization and native or bilingual English proficiency.
• Familiarity with cloud-based communication tools: Google Suite, Slack, Zoom, Dropbox, Salesforce.

Responsibilities

• Lead delegated credentialing program end-to-end, including onboarding, primary source verification, credentialing committee operations, and NCQA audits.
• Set long-term credentialing strategy and manage day-to-day team performance.
• Collaborate with Commercial Strategy, RevOps, RCM, and Compliance to expand delegated statuses and resolve payor issues; drive automation/AI improvements.

Skills

Provider credentialing

Health plan enrollment

People management

Cross-functional collaboration

Process improvement

AI/Automation awareness

English proficiency

Cloud-based tools familiarity

Education

Bachelor's degree

Tools

Google Suite

Slack

Zoom

Dropbox

Salesforce

Job description

Why Charlie Health?

Millions of people across the country are navigating mental health conditions, substance use disorders, and eating disorders, but too often, they're met with barriers to care. From limited local options and long wait times to treatment that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported.

Charlie Health exists to change that. Our mission is to connect the world to life-saving behavioral health treatment. We deliver personalized, virtual care rooted in connection-between clients and clinicians, care teams, loved ones, and the communities that support them. By focusing on people with complex needs, we're expanding access to meaningful care and driving better outcomes from the comfort of home.

As a rapidly growing organization, we're reaching more communities every day and building a team that is redefining what behavioral health treatment can look like. If you're ready to use your skills to drive lasting change and help more people access the care they deserve, we'd love to meet you.

About the Role

The Credentialing & Provider Enrollment Manager will lead Charlie Health's credentialing function and the team of specialists responsible for health plan enrollment across Medicaid and Commercial payors. You will own our delegated credentialing program end-to-end - a complex, specialized area spanning provider onboarding, primary source verification, the internal credentialing committee, and required payor and NCQA audits - while setting long-term
credentialing strategy and managing the day-to-day performance of the team.

You will partner cross-functionally with Commercial Strategy, RevOps, RCM, and Compliance to expand delegated credentialing statuses, resolve problem payors, and continuously improve how the team operates, including through automation and AI-enabled tooling. This is a hands-on leadership role for someone who has run a delegated credentialing program before and is excited to both own the details and build the long-term strategy.

We're a team of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. If you're inspired by our mission and energized by the opportunity to increase access to mental healthcare and impact millions of lives in a profound way.

Requirements

• Bachelor's degree


• 5+ years of experience in provider credentialing and/or health plan enrollment


• Direct, hands-on experience owning or operating a delegated credentialing program is required, including primary source verification, credentialing committee operations, and NCQA standards


• 2+ years of people management experience leading a credentialing or enrollment team preferred


• Experience with both Medicaid and Commercial payor enrollment


• Comfort with process improvement and a track record of leveraging automation and emerging technologies (including AI) to streamline operations


• Strong cross-functional collaboration skills across RevOps, RCM, Commercial Strategy, and Compliance


• Work authorized in the United States and native or bilingual English proficiency


• Familiarity with and willingness to use cloud-based communication software - Google Suite, Slack, Zoom, Dropbox, Salesforce

Benefits

Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.

Please note that this role is not available to candidates inAlaska, Maine, Washington DC, New Jersey, California, New York, Massachusetts, Connecticut, Colorado, Washington State, Oregon, or Minnesota.

The total target base compensation for this role will be between $70,000 and $77,500 per year at the commencement of employment. In addition to base compensation, this role also offers a performance bonus. Please note, pay will be determined on an individualized basis and will be impacted by location, experience, expertise, internal pay equity, and other relevant business considerations. Further, cash compensation is only part of the total compensation package, which, depending on the position, may include stock options and other Charlie Health-sponsored benefits.

Our Values

• Connection: Care deeply & inspire hope.


• Congruence: Stay curious & heed the evidence.


• Commitment: Act with urgency & don't give up.

At Charlie Health, we value being an Equal Opportunity Employer. We strive to cultivate an environment where individuals can be their authentic selves. Being an Equal Opportunity Employer means every member of our team feels as though they are supported and belong. We value diverse perspectives to help us provide essential mental health and substance use disorder treatments to all young people.

Charlie Health applicants are assessed solely on their qualifications for the role, without regard to disability or need for accommodation.