Director of Credentialing

PsychPlus; Houston (TX); On-site; USD 120,000 - 170,000; Full time

Job summary

PsychPlus in Houston, TX seeks a Director of Payer Credentialing & Provider Enrollment to lead credentialing and enrollment operations onsite. You will ensure providers are properly credentialed and enrolled with commercial and government payers, and you will support compliance and timely reimbursement.

The role requires strong leadership, CAQH experience, and the ability to drive improvements across workflows and portals, coordinating with RCM, billing, and operations.

Qualifications

• Strong experience in healthcare provider credentialing and payer enrollment.
• Experience with commercial payers, Medicare, and Medicaid.
• Hands-on CAQH experience and use of enrollment portals.
• Ability to lead and manage a credentialing/enrollment team onsite in Houston.

Responsibilities

• Lead and oversee provider credentialing, re-credentialing, and payer enrollment.
• Manage provider enrollment with commercial insurance, Medicare, and Medicaid.
• Ensure timely submission of credentialing and enrollment applications.
• Maintain provider records, expirables, and enrollment information.
• Monitor enrollment timelines and resolve issues.
• Develop and improve credentialing workflows and ensure compliance.
• Lead, train, and support credentialing/enrollment team members.

Skills

Credentialing expertise

Leadership

Project management

Multitasking

Education

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

Tools

CAQH

Payer enrollment portals

Credentialing software

Job description

Director of Payer Credentialing & Provider Enrollment

Location: Houston, TX

Job Type: Full-time

Work Schedule: Onsite

About PsychPlus

PsychPlus is one of the largest private psychiatry and behavioral health organizations in the U.S., providing comprehensive mental health services through psychiatry, therapy, and innovative treatment programs.

About the Role

We are seeking an experienced Director of Payer Credentialing & Provider Enrollment to lead our provider credentialing and payer enrollment operations. This role will ensure providers are properly credentialed, enrolled, and maintained with commercial and government payers while supporting compliance, timely reimbursement, and operational efficiency.

Key Responsibilities

• Lead and oversee provider credentialing, re-credentialing, and payer enrollment.
• Manage provider enrollment with commercial insurance, Medicare, and Medicaid.
• Ensure accurate and timely submission of credentialing and enrollment applications.
• Maintain provider records, expirables, and enrollment information.
• Manage CAQH profiles and payer enrollment portals.
• Monitor enrollment timelines and resolve credentialing or enrollment issues.
• Develop and improve credentialing and enrollment processes and workflows.
• Ensure compliance with payer requirements and applicable credentialing standards.
• Partner with RCM, billing, providers, and operational teams to resolve payer-related issues.
• Track credentialing and enrollment metrics, deadlines, and provider participation.
• Lead, train, and support credentialing/enrollment team members.

Required Qualifications

• Strong experience in healthcare provider credentialing and payer enrollment.
• Strong experience with commercial payers, Medicare, and/or Medicaid.
• Hands-on experience with CAQH and payer enrollment portals.
• Strong understanding of credentialing, re-credentialing, provider enrollment, and payer requirements.
• Experience managing provider records, applications, expirables, and enrollment documentation.
• Strong leadership, organizational, and problem-solving skills.
• Ability to manage multiple priorities and meet strict deadlines.
• Willingness and ability to work onsite in Houston, TX.

Preferred Qualifications

• Experience leading a credentialing or provider enrollment department.
• Knowledge of NCQA credentialing standards.
• Experience with credentialing software and healthcare information systems.
• Bachelor’s degree in Healthcare Administration, Business, or a related field.

Why Join PsychPlus?

Join a rapidly growing mental health organization focused on expanding access to quality behavioral healthcare. You’ll have the opportunity to build and improve processes while working with a growing team dedicated to better patient and provider experiences.