Director of Payer Credentialing

PsychPlus; Houston (TX); On-site; USD 150,000 - 190,000; Full time

Job summary

PsychPlus, a leading behavioral health organization, seeks a Director of Payer Credentialing & Provider Enrollment to lead credentialing, enrollment, and compliance across commercial and government payers. This on-site role in Houston requires managing CAQH profiles, team leadership, and cross-department collaboration to improve reimbursement timelines and data integrity.

The successful candidate will drive process improvements, ensure timely submissions, and maintain accurate records while

Qualifications

• 5+ years of experience in provider credentialing and payer enrollment.
• Experience with commercial payers, Medicare and/or Medicaid.
• Hands-on experience with CAQH and payer enrollment portals.
• Strong knowledge of credentialing, re-credentialing and payer requirements.
• Experience managing provider records, applications and enrollment documentation.
• Excellent leadership, organizational and problem-solving skills.
• Onsite work ability in Houston, TX.

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 credentialing standards.
• Collaborate with RCM, billing and operations to resolve payer issues.
• Track credentialing and enrollment metrics and deadlines.
• Lead, train and support credentialing/enrollment team members.

Skills

Leadership

Project management

Detail orientation

Communication

Healthcare industry knowledge

Education

Bachelor’s degree in Healthcare Administration 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.