Strategic Credentialing Manager, Payor Enrollments

Charlie Health; Nashville (TN); Presencial; USD 70 000 - 78 000; Tempo integral

Resumo da oferta

Charlie Health in Nashville, Tennessee is seeking a Credentialing & Provider Enrollment Manager to lead our delegated credentialing function across Medicaid and Commercial payors. You will own the end-to-end process, including primary source verification, credentialing committee operations, and NCQA audits, while shaping the long-term strategy and guiding the team.

You will collaborate with Commercial Strategy, RevOps, RCM, and Compliance to expand delegated statuses, improve workflows with

Qualificações

• Bachelor's degree required.
• 5+ years of experience in provider credentialing and/or health plan enrollment.
• Direct, hands-on experience owning or operating a delegated credentialing program with primary source verification, credentialing committee operations, and NCQA standards.
• 2+ years of people management experience leading a credentialing or enrollment team.
• Experience with Medicaid and Commercial payor enrollment.
• Experience with automation and emerging technologies (including AI) to streamline operations.
• Strong cross-functional collaboration across RevOps, RCM, Commercial Strategy, and Compliance.
• US work authorization and native or bilingual English proficiency.
• Familiarity with cloud-based communication tools: Google Suite, Slack, Zoom, Dropbox, Salesforce.

Responsabilidades

• Lead delegated credentialing program end-to-end, including onboarding, primary source verification, credentialing committee operations, and NCQA audits.
• Set long-term credentialing strategy and manage day-to-day team performance.
• Collaborate with Commercial Strategy, RevOps, RCM, and Compliance to expand delegated statuses and resolve payor issues; drive automation/AI improvements.

Conhecimentos

Provider credentialing

Health plan enrollment

People management

Cross-functional collaboration

Process improvement

AI/Automation awareness

English proficiency

Cloud-based tools familiarity

Formação académica

Bachelor's degree

Ferramentas

Google Suite

Slack

Zoom

Dropbox

Salesforce

Descrição da oferta de emprego

Charlie Health in Nashville, Tennessee is seeking a Credentialing & Provider Enrollment Manager to lead our delegated credentialing function across Medicaid and Commercial payors. You will own the end-to-end process, including primary source verification, credentialing committee operations, and NCQA audits, while shaping the long-term strategy and guiding the team.

You will collaborate with Commercial Strategy, RevOps, RCM, and Compliance to expand delegated statuses, improve workflows with