Senior Credentialing & Payer Enrollment Manager

Jobtailor; Chillicothe (OH); On-site; USD 70,000 - 95,000; Full time

Job summary

Jobtailor is seeking an experienced Credentialing Manager to oversee provider credentialing, recredentialing, and payer enrollment in Ohio. You will lead a team, manage workflow, and ensure timely submissions while maintaining compliance with regulatory requirements.

The role requires 5+ years in credentialing, 3+ years in supervision, and strong knowledge of Ohio Medicaid processes. Expect collaboration with billing, HR, and leadership across programs and locations.

Qualifications

• Bachelor's degree in a relevant field.
• 5 years of provider credentialing and payer enrollment experience in healthcare.
• 3 years of supervisory or management experience in credentialing.
• Experience with Ohio Medicaid provider enrollment and credentialing.
• Experience with credentialing systems and electronic health records (EHR).
• Knowledge of credentialing standards and regulatory compliance.
• Ability to manage multiple projects and priorities independently.
• Advanced analytical and organizational skills.
• Proficiency with databases, spreadsheets, and MS Office.

Responsibilities

• Oversee all credentialing, recredentialing, payer enrollment, and provider maintenance activities.
• Manage the credentialing team and coordinate daily workflow.
• Lead performance management, recruitment, onboarding, and team development.
• Ensure timely submission and follow-up of credentialing applications.
• Maintain credentialing files and ensure licenses, certifications, and registrations are current.
• Monitor enrollment status with Ohio Medicaid, Medicare, and other payers.
• Resolve complex credentialing and payer enrollment issues.
• Develop and maintain credentialing policies, procedures, and QA standards.
• Collaborate with billing, compliance, HR, and clinical leadership to support goals.
• Coordinate credentialing for new programs, services, and locations.
• Participate in audits and accreditation activities.
• Maintain HIPAA compliance and safety regulations.

Skills

Credentialing

Payer enrollment

Supervisory

Regulatory compliance

Analytical

Communication

Education

Bachelor's degree in Business/Public Health/Healthcare Admin

Tools

NPPES

CAQH

OH Medicaid PNM

EHR systems

Payer portals

Job description

Jobtailor is seeking an experienced Credentialing Manager to oversee provider credentialing, recredentialing, and payer enrollment in Ohio. You will lead a team, manage workflow, and ensure timely submissions while maintaining compliance with regulatory requirements.

The role requires 5+ years in credentialing, 3+ years in supervision, and strong knowledge of Ohio Medicaid processes. Expect collaboration with billing, HR, and leadership across programs and locations.