Provider Credentialing & Contracting Lead

NIVA Health; United States; Remote; USD 120,000 - 150,000; Full time

Job summary

NIVA Health is seeking an experienced credentialing leader in the United States to own the end-to-end provider lifecycle—from accepted offer to credentialing, contracting, payer enrollment, ongoing maintenance, and eventual offboarding.

You will manage internal and external stakeholders, optimize processes for scalability, and ensure timely provider readiness across markets, while maintaining audit-ready files and KPI reporting.

Qualifications

• 5+ years of progressive experience in provider credentialing, payer enrollment, provider contracting, or healthcare operations.
• Strong working knowledge of Medicare, Medicaid, and commercial payer enrollment.
• Experience with provider credentialing and contracting, including collaborative practice agreements.
• Experience managing multiple onboarding and credentialing projects simultaneously.
• Experience managing or holding a third-party credentialing vendor accountable.
• Advanced Microsoft Excel and reporting skills.
• Experience with provider databases and credentialing software.
• Excellent written and verbal communication skills.
• A bachelor’s degree in Healthcare Administration, Business Administration, Human Resources, or related field is preferred.

Responsibilities

• Own the credentialing process from accepted offer through provider readiness and ongoing maintenance.
• Manage and hold third-party credentialing vendor accountable for timelines, quality, service levels, and results.
• Establish credentialing priorities based on provider start dates, patient access, business growth, geographic expansion, and payer requirements.
• Lead regular status reviews, identify barriers and delays, and escalate risks that could impact provider start dates or patient care.
• Oversee provider contracting, including employment, independent contractor, collaborative practice agreements, supervising physician, medical director, telehealth, delegation, and related agreements.
• Ensure provider contracts are executed before patient care begins and maintain renewal and expiration schedules.
• Oversee Medicare, Medicaid, and commercial payer enrollment and maintain accurate enrollment reporting.
• Partner with Revenue Cycle and Billing to resolve enrollment-related issues that affect claims and reimbursement.
• Own provider lifecycle maintenance, including licenses, certifications, DEA registrations, malpractice coverage, collaborative agreements, practice locations, supervising physicians, and state expansions.
• Lead the credentialing and contracting side of provider offboarding, ensuring payer notifications, contract terminations, and system updates happen accurately and on time.
• Maintain complete, current, audit-ready provider files.
• Develop KPIs, dashboards, SOPs, and reporting that give leadership clear visibility into credentialing performance.
• Identify opportunities for automation, process improvement, and standardization.
• Serve as NIVA Health’s subject matter expert on provider credentialing operations.
• Partner closely with HR, Clinical Operations, Revenue Cycle, Billing, Finance, Compliance, Legal, and Executive Leadership.

Skills

Credentialing

Payer enrollment

Project management

Excel skills

Vendor management

Education

Bachelor's degree in Healthcare Administration

Tools

Credentialing software

Provider databases

Job description

NIVA Health is seeking an experienced credentialing leader in the United States to own the end-to-end provider lifecycle—from accepted offer to credentialing, contracting, payer enrollment, ongoing maintenance, and eventual offboarding.

You will manage internal and external stakeholders, optimize processes for scalability, and ensure timely provider readiness across markets, while maintaining audit-ready files and KPI reporting.