Director, Credentialing & Enrollment Ops

Eleanor Health; United States; On-site; USD 140,000 - 160,000; Full time

Benefits offered by this job

Paid time off

Medical and dental insurance

401(k) with match

Short-term disability

Long-term disability

Life Insurance

Paid Family & Medical Leave

Wellness perks

Job summary

Eleanor Health is seeking a Director of Credentialing & Enrollment to lead credentialing, privileging, and payer enrollment operations. You will ensure compliance with NCQA and The Joint Commission, drive strategic initiatives, and optimize workflows to support member care and revenue cycle continuity.

Lead a national team, build scalable processes, and manage vendor relationships while delivering timely credentialing and enrollment for providers across multiple sites.

Qualifications

• 7+ years of progressive experience in credentialing and/or payer enrollment, including at least 3 years in a leadership role.
• Ability to manage teams, build scalable processes, and drive operational efficiency nationally.
• Strong analytical, organizational, and communication skills for a fast-growing, multi-site environment.
• Knowledge of federal and state regulations in credentialing and enrollment.
• Familiarity with CAQH, NPPES, PECOS, and payer portals.
• Understanding of NCQA and The Joint Commission standards.

Responsibilities

• Direct the credentialing and payer enrollment departments, setting strategic goals, policies, and performance standards.
• Act as SME for provider credentialing/regulations, policies and standards.
• Build and manage a high-performing team, including hiring, training, coaching, and performance management.
• Develop and implement process improvements to reduce enrollment turnaround time and credentialing backlogs.
• Collaborate with Revenue Operations to resolve enrollment-related claim denials or delays.
• Maintain strong relationships with the Credentialing and Enrollment vendor and ensure SLAs are met.
• Develop dashboards and reports to track key metrics and report to leadership.
• Communicate with providers and internal stakeholders regarding day-to-day credentialing operations.
• Identify and mitigate compliance risks, escalating issues to senior leadership as needed.
• Stay up-to-date with industry regulations and participate in audits and regulatory reviews.

Skills

Credentialing & Enrollment

Leadership

Process improvement

Data analysis

Communication

Training materials

Tools

CAQH

NPPES

PECOS

Payer credentialing portals

Job description

Eleanor Health is seeking a Director of Credentialing & Enrollment to lead credentialing, privileging, and payer enrollment operations. You will ensure compliance with NCQA and The Joint Commission, drive strategic initiatives, and optimize workflows to support member care and revenue cycle continuity.

Lead a national team, build scalable processes, and manage vendor relationships while delivering timely credentialing and enrollment for providers across multiple sites.