Senior Manager, Contracting & Credentialing

Credentialing & Provider Enrollment:

• Leading end-to-end provider credentialing, provider licensing and recredentialing for MDs and NPs, and any additional allied clinicians across multiple states.
• Overseeing CAQH, PECOS, Medicare, and commercial payer enrollment.
• Ensuring compliance with state licensure, scope of practice, supervision, and collaborative practice requirements.

Payer Contracting & Network Growth:

• Leading payer contracting strategy across commercial, Medicare Advantage, and government payers with direction from Director of Managed Care Contracting.
• Negotiating and evaluating fee schedules , reimbursement rates, and contract terms.
• Supporting payer expansion strategy aligned with business growth, market demand, and clinical capabilities.

Third-Party Vendor Management:

• Managing relationships with credentialing and contracting vendors.
• Defining SLAs, workflows, and performance expectations.
• Auditing vendor work for accuracy, timeliness, and compliance.