Payer Credentialing & Enrollment Director

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

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