Credentialing Manager

USA CLINIC SL; Northbrook (IL); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Health

Dental

Vision

401k & Match

Paid time off

Job summary

USA CLINIC SL seeks a Credentialing Manager in Northbrook, IL to manage credentialing operations and ensure timely provider onboarding while implementing process improvements and automation.

The ideal candidate will have over 5 years of provider credentialing experience and strong knowledge of Medicare, Medicaid, and CAQH enrollment processes. This full-time position offers competitive compensation and benefits including health, dental, and 401k matching.

Qualifications

• Minimum 5 years of provider credentialing experience.
• Strong knowledge of CAQH, Medicare, Medicaid, and commercial payer enrollment.
• Experience managing credentialing workflows and productivity metrics.

Responsibilities

• Manage credentialing and payer enrollment operations.
• Monitor productivity, application status, and onboarding timelines.
• Train and mentor credentialing staff, ensuring regulatory compliance.

Skills

Credentialing processes

Provider enrollment

Automation tools

Team management

Education

Associate's or Bachelor's degree in Healthcare Administration

Tools

Credentialing software

Reporting tools

Document management systems

Job description

Position Summary

The Credentialing Manager serves as the operational partner to credentialing leadership by managing day-to-day credentialing and enrollment activities, team performance, and workflow optimization. This role focuses on improving efficiency, implementing automation, and ensuring timely provider onboarding and compliance.

Position Details

• Location: Northbrook, IL
• Schedule: Full-time, Monday through Friday on-site.
• Compensation: $75,000 - $95,000

Key Responsibilities

• Manage day-to-day credentialing and payer enrollment operations, ensuring timely completion of provider applications and renewals.
• Monitor department productivity, application status, enrollment aging, and onboarding timelines.
• Develop and maintain operational reports, dashboards, and KPI tracking tools.
• Standardize credentialing processes, maintain SOPs, and identify opportunities to reduce delays and improve efficiency.
• Train, mentor, and support credentialing staff while ensuring adherence to payer and regulatory requirements.
• Coordinate escalations with payers, providers, and internal stakeholders to resolve enrollment issues.
• Serve as the operational partner to the Director by leading process improvements and executing department initiatives.

AI & Automation Responsibilities

• Automate provider status updates, enrollment tracking, and stakeholder communications.
• Implement automated alerts for expiring licenses, certifications, malpractice coverage, and payer renewals.
• Develop AI-assisted dashboards that monitor application progress, aging, and team productivity.
• Utilize automation tools to reduce manual document collection, tracking, and reporting activities.

Requirements

• Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, or related field preferred.
• Minimum 5 years of provider credentialing and payer enrollment experience.
• Strong knowledge of CAQH, Medicare, Medicaid, commercial payer enrollment, and provider licensing requirements.
• Experience managing credentialing workflows, productivity metrics, and provider onboarding timelines.
• Proficiency with credentialing software, reporting tools, and document management systems.

Benefits

• Health
• Dental
• Vision
• 401k & Match
• Paid time off