Director of Credentialing & Enrollment Excellence

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

Benefits offered by this job

Paid Time Off

Wellness benefits

401(k) match

Life Insurance

Job summary

Eleanor Health is seeking a Director of Credentialing & Enrollment to lead credentialing, privileging, and payer enrollment operations. You will oversee a national team, ensure regulatory compliance with NCQA and The Joint Commission, and optimize workflows to credential and enroll providers in a timely manner to support care delivery and revenue cycle continuity.

The role drives strategic goals, builds efficient processes, and partners with revenue operations and a vendor to meet SLAs.

Qualifications

• 7+ years in credentialing and/or payer enrollment, including leadership
• Knowledge of federal and state regulations affecting credentialing and enrollment
• Experience building scalable processes and leading teams
• Familiarity with CAQH, NPPES, PECOS and payer portals
• Ability to analyze data and develop training/documentation materials

Responsibilities

• Direct credentialing and payer enrollment departments, setting goals and standards
• Act as SME for credentialing regulations and standards
• Build and manage a high-performing team
• Develop and implement processes to reduce turnaround time
• Collaborate with Revenue Operations to resolve enrollment denials
• Manage vendor relationships and ensure SLAs
• Develop dashboards to track metrics and report to leadership
• Communicate with providers and internal stakeholders on credentialing/enrollment
• Identify and mitigate compliance risks
• Stay updated on regulatory requirements and participate in audits

Skills

Credentialing & Enrollment leadership

Regulatory compliance

Team leadership

Process improvement

Data analysis

Tools

CAQH

NPPES

PECOS

payer enrollment portals

Job description

Eleanor Health is seeking a Director of Credentialing & Enrollment to lead credentialing, privileging, and payer enrollment operations. You will oversee a national team, ensure regulatory compliance with NCQA and The Joint Commission, and optimize workflows to credential and enroll providers in a timely manner to support care delivery and revenue cycle continuity.

The role drives strategic goals, builds efficient processes, and partners with revenue operations and a vendor to meet SLAs.