Credentialing Manager | ABA

Behavior Frontiers; El Segundo (CA); On-site; USD 80,000 - 85,000; Full time

Benefits offered by this job

Competitive pay

401K Plan with company match

Paid Personal Time Off

Paid Holidays

Medical, Dental and Vision Insurance

Telehealth

Employee Assistance Program

Gym membership discounts

Travel discounts

Lab testing discounts

Rx discounts

Job summary

Behavior Frontiers is seeking a Credentialing Department leader to supervise daily operations, ensure timely credentialing, enrollment and provider maintenance across states. You will collaborate with internal teams and payers, maintain data integrity, and drive improvements in processes and SOPs.

The role requires 3–5 years in healthcare credentialing, a bachelor’s degree in a related field, and strong organizational and leadership skills.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Healthcare Management, or related field preferred / equivalent experience.
• 3–5 years of healthcare credentialing, provider enrollment, contracting, or related experience.
• Leadership experience in supervision or management preferred.
• Multi-State credentialing and provider enrollment experience strongly preferred.
• Payer knowledge with commercial insurance plans, Medicaid, Medicare, Tricare, and other funding sources preferred.
• Systems proficiency with CAQH, NPPES, PECOS, payer portals, and credentialing databases.
• Core competencies include strong organizational, analytical, problem-solving and project management skills.
• Time management to handle multiple priorities and deadlines across departments.

Responsibilities

• Supervise daily operations of the Credentialing Department, manage workflow distribution, prioritization and staff development.
• Oversee credentialing, recredentialing, enrollment and provider maintenance to ensure compliance with payer, regulatory and organizational requirements.
• Collaborate with payer representatives and regulatory agencies; support provider onboarding and roster maintenance.
• Participate in strategic planning for market expansion and funding source research; track department metrics and drive process improvements.
• Develop and maintain SOPs and policies; uphold confidentiality of PHI, employees, and company operations.

Skills

Organizational skills

Analytical

Project management

Time management

Cross-department collaboration

Communication

Education

Bachelor's degree in Healthcare Administration

Tools

CAQH

NPPES

PECOS

Payer portals

Credentialing databases

Job description

Behavior Frontiers

Salary Range: $80,000 - $85,000

Responsibilities

Team Leadership & Daily Operations

As the leader of our Credentialing Department, you will supervise and manage daily operations, focusing on workflow distribution, prioritization, and employee development. You will actively monitor application statuses, processing timelines, and department work queues to quickly identify and resolve delays or barriers. In this capacity, you will serve as the primary escalation point for complex credentialing, enrollment, contracting, and payer-related issues. You will also drive team success through continuous training, performance management, and quality assurance initiatives.

Credentialing, Compliance & Data Integrity

You will oversee all credentialing, recredentialing, enrollment, and provider maintenance activities to ensure strict compliance with payer, regulatory, and organizational requirements. A core part of this role involves ensuring that provider licenses, certifications, NPI records, and CAQH profiles remain perfectly current. To maintain operational visibility and data integrity, you will manage departmental databases and tracking tools while conducting regular audits of provider files. You will also be responsible for developing and maintaining the department's standard operating procedures (SOPs) and policies, all while upholding strict confidentiality regarding protected health information, employees, and company operations.

Stakeholder Collaboration & Strategic Growth

Collaboration is essential in this role. You will build and maintain effective relationships with payer representatives and regulatory agencies, while partnering internally with Operations, Recruiting, HR, and Clinical Leadership to support seamless provider onboarding and location roster maintenance. As the organization grows, you will participate in strategic planning related to market expansion by supporting contract development initiatives, researching new funding sources, and staying highly informed on federal, state, and accreditation requirements. By tracking key department metrics, you will prepare reports for leadership and lead continuous process improvement initiatives to increase the department’s overall efficiency and scalability. You will also take on special projects and additional duties as assigned.

Qualifications

• Education: Bachelor's degree in Healthcare Administration, Business Administration, Healthcare Management, or a related field preferred; equivalent experience may be considered.
• Experience: 3–5 years of healthcare credentialing, provider enrollment, contracting, or related experience required.
• Leadership: Previous supervisory, lead, or management experience preferred.
• Multi-State Expertise: Multi-state credentialing and provider enrollment experience strongly preferred.
• Payer Knowledge: Experience working with commercial insurance plans, Medicaid, Medicare, Tricare, and other funding sources preferred.
• Systems Proficiency: Experience with CAQH, NPPES, PECOS, payer portals, and credentialing databases.
• Core Competencies: Strong organizational, analytical, problem-solving, and project management skills.
• Time Management: Ability to manage multiple priorities, meet deadlines, and collaborate effectively across departments.

Why Behavior Frontiers is perfect for you:

• Competitive pay with optional On-Demand paychecks through DailyPay – get paid on your own schedule!
• 401K Plan with company match after 6 months of employment
• Paid Personal Time Off
• Paid Holidays
• Medical, Dental and Vision Insurance
• Performance and promotion raises
• Free Telehealth: Free 24/7 access to a doctor via telehealth for you and your dependents with no limits and no co-pays
• Free Telehealth Mental Health: Free access to a mental health counselor via telehealth for you and your dependents (over age 13) with no limits or co-pays
• Employee Assistance Program: Free access to some support services (financial, legal, counseling etc.)
• Fitness: Discounted monthly gym membership to 12,000 gym locations nationwide, as well as free access to workout videos
• Deals: Exclusive discounts and savings to 500+ companies and more!
• Travel: Discounts of travel essentials including hotels, rental cars, flights, excursions and more!
• Lab Testing Discounts: 10-80% off costs of routine lab work
• New Benefits RX: Discounts on prescription medications from 10-80% at 60,000+ locations nationwide Why work for Behavior Frontiers? Visit our benefits & perks page to learn more!

Behavior Frontiers is an Equal Opportunity Employer and will consider for employment all qualified applicants in a manner consistent with the requirements of the applicable federal, state, and local laws.