Source Job

• Responsible for the strategic oversight, execution, and continuous improvement of all provider credentialing, re-credentialing, payer enrollment, contracting coordination, and licensure activities across all AnswersNow business entities.
• Ensures that providers and groups are credentialed, contracted, and licensed accurately and on time so that services may be delivered, billed, and reimbursed without delay.
• Leads the credentialing team, manages external vendors, partners cross-functionally with RCM, growth, operations, scheduling, and technology teams, and delivers clear, data-driven reporting to executive leadership.

AnswersNow is innovating autism therapy by making it more immediate, accessible, and effective for families. Their remote team allows for a flexible work-from-home environment, providing client support without the need to report on-site.

• Lead the preparation and submission of comprehensive provider rosters to Managed Medicare, Medicaid, and commercial payers.
• Audit internal provider data against database records to ensure 100% accuracy before submission.
• Serve as the primary point of contact for health plans to resolve roster discrepancies, rejections, or paneling delays.

Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs.

• Lead the full credentialing lifecycle for new and existing providers and practice locations including Medicare and Medicare Advantage plans.
• Ensure CAQH profiles are complete, current, and accurately reflect provider credentials and practice information.
• Assess current credentialing processes, identify inefficiencies, and implement improvements using Airtable, automation tools, and best practices.

Sailor Health is on a mission to solve the mental health crisis among older adults, building the platform for senior mental health.

The Provider Enrollment Specialist is responsible for timely and effectively enrolling practitioners in health plans. The Specialist will monitor progress, ensure timeliness of enrollment completion, and provide updates. The Specialist will maintain accurate provider profiles in IntelliCred and CAQH.

Pediatrix Medical Group is one of the nation’s leading providers of specialized health care for women, babies and children since 1979.

• Responsible for economic credentialing and provider enrollment with contracted managed care and governmental plans.
• Communicating provider participation information to internal and external customers.
• Ensures compliance with regulatory agencies and maintains a working knowledge of statues and laws.

The West Virginia University Health System is West Virginia’s largest health system and the state’s largest employer. They have more than 3,400 licensed beds, 4,600 providers, 35,000 employees, and $7 billion in total operating revenues.

• Ensuring providers are credentialed in a timely manner by monitoring the submission process.
• Monitoring submission processes, updating protocols, and managing Virtual Assistants/BPO.
• Communicating with payors and conducting regular reviews to validate internal credentialing data.

Grow Therapy aims to be the trusted partner for therapists growing their practice, and patients accessing high-quality care. They are a three-sided marketplace that empowers providers, augments insurance payors, and serves patients and have empowered more than ten thousand therapists.

• Lead and supervise credentialing support staff, ensuring quality, accuracy, and timely processing of credentialing and enrollment tasks.
• Oversee provider credentialing, licensure, and internal enrollment with Medicare, Medicaid, Managed Care, and Commercial Plans.
• Maintain provider rosters, monitor license and certification renewals, and ensure compliance with regulatory and internal standards.

At Better Life Partners, we provide what it takes to heal from addiction. Wherever. Whenever. By combining virtual and in-person counseling, community support, and medication access.

• Manage all aspects of provider licensing, credentialing, and payer enrollment.
• Coordinate end-to-end licensing workflows and maintain accurate records.
• Act as a key liaison between clinicians, state boards, payers, and internal stakeholders.

They are committed to providing safe, discreet medication abortion treatment and offer a range of reproductive and sexual health care services. The in-house clinical care team composed of board-certified doctors, advanced practice clinicians, nurses, and patient care advocates, is just a text message away.

Acts as key point of contact for the processing of enrollment applications for all providers. Works with System Credentialing and local medical staff contacts. Responsible for completing the ongoing review and attestation of all Munson Healthcare provider enrollment records.

Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents.

Manage contracting and credentialing activities with insurance companies and Medicaid agencies. Oversee the provider enrollment, application, and credentialing process. Serve as the point of contact for contract negotiations and expedite approvals.

Amity Foundation is a safe place where people can change in an environment that fosters trust; where new values can be formed, responsibility developed, and lasting relationships built.

• Ensure adherence to payer requirements and internal compliance standards.
• Support audit readiness, reduce denials, and improve claim resolution.
• Maintain payer setup and readiness including fee schedules.

Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services, serving thousands of clients.

Oversee the operations of the Imagine Pediatrics Onboarding, Credentialing, Licensing, and Enrollment Department. Develop and train on policies and procedures, workflows, and training documentation for the team. Manage Delegated Credentialing arrangements - implementation and audit – as well as ongoing Delegated partnerships with health plans.

Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs.

• Provides data management support services to Dignity Health’s CI/ACO Networks, Employer Relations and Valued Based Operations (VBO).
• Within the Salesforce platform, this individual gathers and maintains accurate provider data, performs periodic provider data reconciliations with multiple data sources.
• Maintains and transmits fee schedules, as necessary, to third-party administrators (TPA's) and other appropriate stakeholders.

Dignity Health MSO builds a system-wide integrated physician-centric, full-service management service organization structure. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers.