Senior Manager, Credentialing

UPMC; Pittsburgh (Allegheny County); Remote; USD 120,000 - 180,000; Full time

Job summary

UPMC is seeking a Senior Manager, Credentialing to provide strategic leadership and operational oversight for credentialing and provider enrollment across a complex healthcare environment. This primarily remote leadership role will guide a team of about 30 direct reports, ensuring timely credentialing and enrollment while maintaining accuracy and compliance.

The role partners with physician leadership, practice administrators, payers, and compliance teams to drive process improvements, monitor

Qualifications

• Strong leadership experience in credentialing, provider enrollment, or healthcare operations.
• Ability to manage large teams and drive process improvements.
• Experience monitoring key performance indicators and fostering accountability.

Responsibilities

• Lead and manage the credentialing department, including supervision and staff development.
• Oversee initial credentialing, recredentialing, and enrollment for physicians and APPs across locations.
• Ensure compliance with federal, state, and accreditation standards (e.g., JCAHO, NCQA).
• Serve as expert user of credentialing software (CredentialStream, MSOW).
• Develop and implement policies, procedures, and workflows to improve efficiency and data accuracy.
• Coordinate with medical staff offices, enrollment teams, legal, and other stakeholders.
• Conduct audits and quality assurance checks to maintain data integrity.
• Provide training and orientation for staff on credentialing processes and systems.
• Monitor productivity and equitable workload distribution.
• Represent the credentialing department in organizational meetings and initiatives.
• Maintain confidentiality of provider information and data security.

Skills

Strategic leadership

Team management

Healthcare operations

Process improvement

KPI monitoring

Staff development

Cross-functional collaboration

Tools

CredentialStream

MSOW

Job description

Join our team as a Senior Manager, Credentialing, where you will provide strategic leadership and operational oversight for credentialing and provider enrollment functions across a complex healthcare environment. This work-from-home leadership role is responsible for managing credentialing operations, ensuring compliance with regulatory and accreditation requirements, and driving process improvements that support organizational goals and provider experience.

The Senior Manager, Credentialing will lead a team of approximately 30 direct reports, overseeing day-to-day credentialing activities, provider enrollment, quality assurance, performance management, staff development, and operational excellence initiatives. This role partners closely with physician leadership, practice administrators, payers, compliance teams, and other key stakeholders to ensure timely credentialing, recredentialing, and enrollment of providers while maintaining accuracy and compliance with all applicable standards.

Successful candidates will bring strong leadership experience within credentialing, provider enrollment, healthcare operations, or a related field, along with a demonstrated ability to manage large teams, implement process improvements, monitor key performance indicators, and foster a culture of accountability and continuous improvement. This is a primarily remote position with occasional travel, approximately once per month as needed, to support team engagement, operational meetings, and organizational initiatives.

Responsibilities

• Lead and manage the credentialing department, including staff supervision, performance evaluations, and professional development.
• Oversee initial credentialing, recredentialing, and enrollment processes for physicians and advanced practice providers across multiple locations.
• Ensure compliance with federal, state, and accreditation standards (e.g., JCAHO, NCQA).
• Serve as the expert user of credentialing software (e.g., CredentialStream, MSOW), resolving issues and maximizing system functionality.
• Develop and implement policies, procedures, and workflows to improve efficiency and data accuracy.
• Coordinate with medical staff offices, enrollment teams, legal, and other stakeholders to ensure seamless credentialing operations.
• Conduct audits and quality assurance checks to maintain data integrity and identify areas for improvement.
• Provide training and orientation for new and existing staff on credentialing processes and systems.
• Monitor productivity and ensure equitable distribution of work across the team.
• Represent the credentialing department in organizational meetings and initiatives.
• Maintain confidentiality of provider information and ensure secure handling of sensitive data.