Strategic Credentialing Leader

Behavior Frontiers; El Segundo (CA); On-site; USD 80,000 - 85,000; Full time

Benefits offered by this job

Competitive pay

401K Plan with company match

Paid Personal Time Off

Paid Holidays

Medical, Dental and Vision Insurance

Telehealth

Employee Assistance Program

Gym membership discounts

Travel discounts

Lab testing discounts

Rx discounts

Job summary

Behavior Frontiers is seeking a Credentialing Department leader to supervise daily operations, ensure timely credentialing, enrollment and provider maintenance across states. You will collaborate with internal teams and payers, maintain data integrity, and drive improvements in processes and SOPs.

The role requires 3–5 years in healthcare credentialing, a bachelor’s degree in a related field, and strong organizational and leadership skills.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Healthcare Management, or related field preferred / equivalent experience.
• 3–5 years of healthcare credentialing, provider enrollment, contracting, or related experience.
• Leadership experience in supervision or management preferred.
• Multi-State credentialing and provider enrollment experience strongly preferred.
• Payer knowledge with commercial insurance plans, Medicaid, Medicare, Tricare, and other funding sources preferred.
• Systems proficiency with CAQH, NPPES, PECOS, payer portals, and credentialing databases.
• Core competencies include strong organizational, analytical, problem-solving and project management skills.
• Time management to handle multiple priorities and deadlines across departments.

Responsibilities

• Supervise daily operations of the Credentialing Department, manage workflow distribution, prioritization and staff development.
• Oversee credentialing, recredentialing, enrollment and provider maintenance to ensure compliance with payer, regulatory and organizational requirements.
• Collaborate with payer representatives and regulatory agencies; support provider onboarding and roster maintenance.
• Participate in strategic planning for market expansion and funding source research; track department metrics and drive process improvements.
• Develop and maintain SOPs and policies; uphold confidentiality of PHI, employees, and company operations.

Skills

Organizational skills

Analytical

Project management

Time management

Cross-department collaboration

Communication

Education

Bachelor's degree in Healthcare Administration

Tools

CAQH

NPPES

PECOS

Payer portals

Credentialing databases

Job description

Behavior Frontiers is seeking a Credentialing Department leader to supervise daily operations, ensure timely credentialing, enrollment and provider maintenance across states. You will collaborate with internal teams and payers, maintain data integrity, and drive improvements in processes and SOPs.

The role requires 3–5 years in healthcare credentialing, a bachelor’s degree in a related field, and strong organizational and leadership skills.