Indiana Credentialing SME: Medicare & Medicaid Expert

Calpion/Plutus Health; Dallas (TX); On-site; USD 120,000 - 160,000; Full time

Job summary

Calpion/Plutus Health seeks a Subject Matter Expert in Provider Credentialing (Indiana) to serve as the authoritative resource for credentialing, re-credentialing, and enrollment activities within Indiana. You will provide strategic guidance, resolve complex cases, and ensure payer alignment while onboarding providers.

The role requires deep Indiana credentialing expertise, strong regulatory knowledge, and collaboration with internal teams and offshore partners to optimize credentialing

Qualifications

• 10+ years of U.S. provider credentialing experience, with deep Indiana focus.
• Strong working knowledge of Indiana Medicaid, Medicare, and commercial payer enrollment.
• Experience using CAQH, PECOS, and NPPES for credentialing workflows.
• Excellent communication, documentation, and stakeholder management skills.

Responsibilities

• Act as SME for Indiana provider credentialing and payer nuances.
• Guide initial credentialing, re-credentialing, and enrollment for Medicare, IHCP, HIP, MCOs, and commercial payers.
• Escalate and resolve complex credentialing cases and payer delays.
• Ensure Indiana-specific regulatory and payer requirements are met for compliance.

Skills

Credentialing expert

Indiana credentialing

Regulatory compliance

Stakeholder management

Tools

CAQH

PECOS

NPPES

Job description

Calpion/Plutus Health seeks a Subject Matter Expert in Provider Credentialing (Indiana) to serve as the authoritative resource for credentialing, re-credentialing, and enrollment activities within Indiana. You will provide strategic guidance, resolve complex cases, and ensure payer alignment while onboarding providers.

The role requires deep Indiana credentialing expertise, strong regulatory knowledge, and collaboration with internal teams and offshore partners to optimize credentialing