Credentialing Program Lead – Hybrid/Remote

Celebration Health & Wellness; Celebration (FL); Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Benefits package

Hybrid/remote work options

Leadership and growth opportunities

Career development in credentialing

Collaborative culture

Job summary

Medinex Healthcare Solutions in Central Florida near Disney is seeking a Medical Insurance Credentialing Lead to design, launch, and lead a new credentialing and payer enrollment function. You will build workflows, manage enrollments, ensure compliance, and hire a Credentialing Assistant as volume grows.

Ideal candidates have deep credentialing expertise, enjoy building programs, and can operate in strategic and hands-on roles. Hybrid/remote options and Florida regulatory knowledge are valued.

Qualifications

• 4+ years of progressive medical insurance credentialing experience.
• Experience managing Medicare, Medicaid, and major commercial payer enrollments.
• Strong knowledge of CAQH ProView, PECOS, NPPES, and enrollment platforms.
• Ability to manage multiple providers and practices concurrently.
• Excellent organizational and communication skills.

Responsibilities

• Design and implement credentialing and re-credentialing programs from the ground up.
• Develop workflows, tracking tools, turnaround standards, and SOPs.
• Support launch of credentialing as an internal/external service offering.
• Oversee provider credentialing for physicians and APNs/PAcs.
• Ensure payer enrollment filings with Medicare, Medicaid, and commercial payers.
• Maintain compliant credentialing files and timely attestation portals.
• Lead reporting on turnaround times, payer approvals, and revenue impact.
• Hire, train, and supervise Credentialing Assistant as volume grows.

Skills

Credentialing experience

Payer enrollment

CAQH ProView

PECOS

NPPES

Attention to detail

Independent work

Education

Bachelor’s degree in Healthcare Administration, Business, or related field

CPCS or CPMSM certification

Tools

CAQH ProView

PECOS

NPPES

Payer enrollment platforms

Job description

Medinex Healthcare Solutions in Central Florida near Disney is seeking a Medical Insurance Credentialing Lead to design, launch, and lead a new credentialing and payer enrollment function. You will build workflows, manage enrollments, ensure compliance, and hire a Credentialing Assistant as volume grows.

Ideal candidates have deep credentialing expertise, enjoy building programs, and can operate in strategic and hands-on roles. Hybrid/remote options and Florida regulatory knowledge are valued.