Director, Credentialing & Payer Enrollment

Essen Health Care; O'Fallon (IL); Hybrid; USD 120,000 - 180,000; Full time

Job summary

Essen Health Care, the largest privately held multispecialty medical group in New York, is seeking an Associate Director to lead provider credentialing, payer enrollment, licensing, and privileging across multiple states. You will ensure compliance with federal, state, and payer regulations while supporting onboarding and multi-state operations.

In this pivotal role, you will supervise the credentialing team, collaborate with Compliance, Contracting, and Revenue Cycle Management, and drive

Qualifications

• Proven experience in provider credentialing, payer enrollment, and privileging.
• Strong leadership and organizational skills.
• Solid knowledge of federal and state regulations and licensing requirements.
• Excellent communication and collaboration with internal and external partners.

Responsibilities

• Lead end-to-end credentialing and payer enrollment across multiple states.
• Oversee licensing, re-licensing, and privileging for facilities.
• Coordinate with Compliance, Contracting, and Revenue Cycle Management.
• Prepare materials for Credentialing Committee reviews twice monthly.
• Mentor and develop the credentialing team and ensure SLAs.

Skills

Provider Credentialing

Payer Enrollment

Licensing & Privileging

Leadership

Regulatory Knowledge

Communication

MS Office

Data Analysis

Education

Bachelor's degree in Healthcare Administration or related field

NAMSS CPCS/CPMSM/CPES preferred

Tools

Credentialing Software

MS Excel

Electronic Health Records (EHR)

Job description

Essen Health Care, the largest privately held multispecialty medical group in New York, is seeking an Associate Director to lead provider credentialing, payer enrollment, licensing, and privileging across multiple states. You will ensure compliance with federal, state, and payer regulations while supporting onboarding and multi-state operations.

In this pivotal role, you will supervise the credentialing team, collaborate with Compliance, Contracting, and Revenue Cycle Management, and drive