Healthcare Credentialing & Compliance Lead (Multi-State)

Evlo AI; Phoenix (AZ); On-site; USD 80,000 - 110,000; Full time

Job summary

Evlo AI in Phoenix, AZ is seeking a healthcare administration professional to own the administrative backbone of compliance operations, provider credentialing, payer coordination, and HIPAA-driven governance across clinical and non-clinical teams.

This role tackles a large regulatory surface including HIPAA, CMS guidelines, and state licensure in multi-state operations, translating requirements into working systems, audits, and workflows that keep the business running safely.

Qualifications

• 4-7 years of healthcare administration experience.
• HIPAA, CMS regulatory knowledge.
• Experience with EHR/PM systems.
• Bachelor's degree in related field; MHA/MBA a plus.
• Strong analytics and reporting in Excel or BI.

Responsibilities

• Own day-to-day healthcare administration: provider credentialing, payer enrollment, licensure tracking, and compliance calendars across multiple states
• Build and maintain compliance processes for HIPAA, OSHA, and CMS requirements, including policy documentation, training programs, and audit readiness
• Manage healthcare information systems and administrative tooling (EHR/PM platforms such as Athenahealth, Epic, or Kareo), coordinating with IT on access controls and data governance
• Oversee vendor and payer relationships, resolving escalations on contracting, claims workflows, and credentialing timelines
• Analyze operational and compliance metrics — denial rates, credentialing turnaround, audit findings — and report KPIs to leadership monthly
• Lead internal audits and remediation plans, ensuring documentation is inspection-ready at all times
• Partner with clinical, legal, and finance teams on policy updates, staffing workflows, and budget planning for administrative functions

Skills

Healthcare admin

HIPAA knowledge

Payer credentialing

KPI reporting

Excel

BI tools

Education

Bachelor's in Healthcare Admin

MHA or MBA

Tools

EHR/PM systems

credentialing tools

Job description

Evlo AI in Phoenix, AZ is seeking a healthcare administration professional to own the administrative backbone of compliance operations, provider credentialing, payer coordination, and HIPAA-driven governance across clinical and non-clinical teams.

This role tackles a large regulatory surface including HIPAA, CMS guidelines, and state licensure in multi-state operations, translating requirements into working systems, audits, and workflows that keep the business running safely.