Remote Director, Credentialing & Enrollment Operations

Socket.dev; United States; On-site; USD 150,000 - 190,000; Full time

Job summary

Socket.dev seeks a Director of Credentialing & Enrollment Services to lead provider credentialing, re-credentialing, and payer enrollment for a diverse healthcare client base. You will manage a global team, set strategic direction, and ensure regulatory excellence across NCQA and CMS standards.

The role emphasizes scalable processes, client satisfaction, and cross-functional collaboration with product and engineering to advance the in-house credentialing platform.

Qualifications

• Requires Bachelor's degree and 5–7+ years in provider credentialing and payer enrollment, with management responsibility.
• Deep working knowledge of NCQA, CMS, CAQH/PECOS/NPPES systems.
• Experience leading multi-site credentialing and enrollment teams.

Responsibilities

• Provide strategic and operational leadership over credentialing, re-credentialing, and payer enrollment for healthcare clients.
• Oversee end-to-end credentialing lifecycle across provider types; ensure regulatory compliance and PSV protocols.
• Direct payer enrollment activities across commercial, Medicare, Medicaid, and managed care payers; manage applications.
• Lead and develop a geographically distributed team; establish KPIs and drive continuous improvement.
• Collaborate with product and engineering teams to enhance credentialing software and workflows.
• Lead initiatives to achieve NCQA CVO certification and ensure ongoing regulatory compliance.

Skills

Leadership

Strategic thinking

Regulatory acumen

People leadership

Problem solving

Data-driven decision making

Change management

Education

Bachelor's degree in Healthcare Administration or related

Tools

Credentialing software platforms

Job description

Socket.dev seeks a Director of Credentialing & Enrollment Services to lead provider credentialing, re-credentialing, and payer enrollment for a diverse healthcare client base. You will manage a global team, set strategic direction, and ensure regulatory excellence across NCQA and CMS standards.

The role emphasizes scalable processes, client satisfaction, and cross-functional collaboration with product and engineering to advance the in-house credentialing platform.