Remote Credentialing & Enrollment Manager

Charlie Health, Inc.; United States; Remote; USD 70.000 - 78.000; Vollzeit

Benefits dieser Stelle

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Benefits package

Zusammenfassung

Charlie Health, Inc. is seeking a Credentialing & Provider Enrollment Manager to lead our credentialing function and a team of specialists responsible for Medicaid and Commercial payor enrollment.

You will own the delegated credentialing program end‑to‑end, drive strategy, and ensure NCQA standards and audits are met. Partner with Commercial Strategy, RevOps, RCM, and Compliance to expand delegated statuses, resolve payor issues, and continuously improve workflows with automation and AI-enabled

Qualifikationen

• Bachelor’s degree required.
• 5+ years in provider credentialing or health plan enrollment.
• Direct hands‑on experience owning delegated credentialing programs.
• 2+ years people management in credentialing/enrollment.
• Experience with Medicaid and Commercial payor enrollment.
• Comfort with automation and AI to improve operations.
• Strong cross‑functional collaboration across RevOps, RCM, Commercial Strategy, Compliance.
• U.S. work authorisation and English proficiency.
• Familiarity with cloud-based collaboration tools (Google Suite, Slack, Zoom, Salesforce).

Aufgaben

• Lead and develop a team of 5+ credentialing specialists; own KPIs like turnaround times and submissions.
• Oversee delegated credentialing end‑to‑end: onboarding, primary source verification, NCQA‑aligned standards.
• Run internal credentialing committee: case presentations, minutes, approvals.
• Manage payor and internal audits; ensure NCQA and delegated credentialing compliance.
• Set long‑term credentialing strategy; partner with Commercial Strategy to expand delegated statuses.
• Create a centralized credentialing source of truth for payor requirements.
• Collaborate with RevOps to align KPIs and incentives; work with RCM on denials.
• Drive process improvements, including automation and AI workflows.
• Oversee day‑to‑day enrollment across group and individual submissions in Salesforce.

Kenntnisse

Provider credentialing

Enrollment management

People management

Medicaid enrollment

Commercial payor enrollment

Automation / AI workflows

Cross‑functional collaboration

Cloud-based tools

Ausbildung

Bachelor's degree

Tools

Salesforce

Google Suite

Slack

Zoom

Dropbox

Jobbeschreibung

Charlie Health, Inc. is seeking a Credentialing & Provider Enrollment Manager to lead our credentialing function and a team of specialists responsible for Medicaid and Commercial payor enrollment.

You will own the delegated credentialing program end‑to‑end, drive strategy, and ensure NCQA standards and audits are met. Partner with Commercial Strategy, RevOps, RCM, and Compliance to expand delegated statuses, resolve payor issues, and continuously improve workflows with automation and AI-enabled