Credentialing Manager/Director

Develop, implement, and enforce policies and procedures for credentialing and payer enrollment across all states and markets. Oversee the full lifecycle of credentialing and recredentialing for providers, ensuring accuracy, compliance, and timeliness. Lead, mentor, and manage credentialing and enrollment staff, including performance management, training, and team development. Ensure accurate, up-to-date provider data in internal systems and payer portals. Monitor and maintain compliance with CMS, NCQA, URAC, federal/state regulations, and payer-specific requirements. Collaborate cross-functionally with finance, contracting, revenue cycle, legal, operations, and clinical leadership to support timely provider onboarding and billing readiness. Serve as the primary point of contact for escalated issues with payers, regulatory agencies, and partner practices. Maintain strong relationships with payer representatives and credentialing contacts. Provide regular status updates and reports to executive leadership, including key performance indicators (KPIs), risk areas, and opportunities for process improvement.