Credentialing Manager: Compliance, Enrollment & Process Improvement

Behavior Frontiers; El Segundo (CA); Presencial; USD 90.000 - 120.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

DailyPay: On-Demand paychecks

401K Plan with company match

Paid Personal Time Off

Medical, Dental and Vision Insurance

Performance and promotion raises

Telehealth: medical services 24/7 for你

Telehealth Mental Health

Employee Assistance Program

Gym membership discounts

Exclusive discounts to 500+ companies

Travel discounts

Lab Testing Discounts

Rx discounts

Descripción de la vacante

Behavior Frontiers is seeking a leader for the Credentialing Department to supervise daily operations, optimize workflow, and coach staff in credentialing, enrollment, and payer relations. You will monitor statuses, timelines, and queues to remove delays and escalate complex issues.

You will oversee credentialing, recredentialing, enrollment, and provider maintenance to ensure strict payer, regulatory, and organizational compliance, while maintaining data integrity across CAQH, NPI records, and

Formación

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

Responsabilidades

• Oversee credentialing, recredentialing, enrollment, and provider maintenance activities to ensure compliance with payer, regulatory, and organizational requirements.
• Ensure provider licenses, certifications, NPI records, and CAQH profiles are current.
• Manage departmental databases and tracking tools; conduct regular audits of provider files.
• Develop and maintain SOPs and policies while upholding confidentiality of PHI, employees, and operations.
• Surveil stakeholder collaboration with payer reps and regulatory agencies; support onboarding and roster maintenance.
• Contribute to strategic planning for market expansion, contract development, and new funding sources.

Conocimientos

Organizational skills

Analytical skills

Problem-solving

Project management

Time management

Leadership

Cross-functional collaboration

Educación

Bachelor's degree in Healthcare Administration, Business Administration, Healthcare Management, or related field

Herramientas

CAQH

NPPES

PECOS

Payer portals

Credentialing databases

Descripción del empleo

Behavior Frontiers is seeking a leader for the Credentialing Department to supervise daily operations, optimize workflow, and coach staff in credentialing, enrollment, and payer relations. You will monitor statuses, timelines, and queues to remove delays and escalate complex issues.

You will oversee credentialing, recredentialing, enrollment, and provider maintenance to ensure strict payer, regulatory, and organizational compliance, while maintaining data integrity across CAQH, NPI records, and