Strategic Credentialing & Enrollment Leader

Watson Clinic; Lakeland (FL); On-site; USD 70,000 - 120,000; Full time

Job summary

Watson Clinic in Lakeland, FL seeks a Credentialing and Enrollment Manager to oversee the daily operations of the Credentialing & Enrollment Department under the Director. This role ensures compliance with NCQA, AAAHC, TJC, and payer standards and provides leadership, training, and quality oversight to staff while collaborating across departments to improve provider onboarding and management.

Responsibilities include end-to-end credentialing and re-credentialing for physicians and allied

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, or a related field (or equivalent professional experience).
• Minimum of 5 years of healthcare credentialing within large health systems/CVOs, provider enrollment, and privileging experience, with at least 2 years in a supervisory or management role.
• Current CPCS or CPMSM certification through NAMSS strongly preferred.
• Strong expertise with NCQA, AAAHC, The Joint Commission, and CMS standards.
• Knowledge of medical staff bylaws and clinical privileging workflows.
• Advanced proficiency with CAQH ProView and MD-Staff credentialing software.

Responsibilities

• Oversee daily operations of the Credentialing & Enrollment Department under the Director’s supervision.
• Credentialing and recredentialing for physicians, NPs, PAs, and allied professionals; monitor start dates and onboarding tasks.
• Verify licenses, DEA certificates, education, board certifications, work history, and malpractice history; address red flags.
• Manage workflow and productivity to align with organizational goals and policies.
• Maintain compliance with internal standards and external regulatory/accreditation requirements.
• Create, draft, and implement privileging forms, criteria, and dockets for clinic and ASC environments.
• Collaborate with leadership and committees to update privilege delineation and competency metrics.
• Coordinate peer references and competency assessments; ensure alignment with licensing boards and scope of practice.
• Manage payer enrollment with commercial plans, Medicare, Medicaid, and managed care; submit CAQH and payer applications timely.
• Maintain provider numbers, effective dates, and contract statuses; oversee day-to-day network enrollment.
• Conduct internal audits and audits preparation; maintain credentialing software databases.

Skills

NCQA knowledge

AAAHC knowledge

Leadership

Communication

Organizational skills

Education

Bachelor's degree in Healthcare Administration or related field

Tools

CAQH ProView

MD-Staff credentialing software

Job description

Watson Clinic in Lakeland, FL seeks a Credentialing and Enrollment Manager to oversee the daily operations of the Credentialing & Enrollment Department under the Director. This role ensures compliance with NCQA, AAAHC, TJC, and payer standards and provides leadership, training, and quality oversight to staff while collaborating across departments to improve provider onboarding and management.

Responsibilities include end-to-end credentialing and re-credentialing for physicians and allied