Manager Of Provider Payer Enrollment And Credentialing (Healthcare)

TL;DR

Manager Of Provider Payer Enrollment And Credentialing (Healthcare): Leading the provider payer enrollment and credentialing program for hirify.global Medical Group with an accent on compliance, onboarding efficiency, and revenue integrity. Focus on designing process improvements, managing delegated credentialing in compliance with NCQA/CMS, and preventing revenue leakage.

Location: Remote (Must be based in the USA)

Company

hirify.global is a large healthcare provider group offering primary, specialty, and urgent care services across Connecticut and Massachusetts.

What you will do

• Lead and oversee provider enrollment and credentialing operations.
• Manage and develop Credentialing Coordinators, Supervisors, and Provider Recruitment Coordinators.
• Serve as a subject matter expert for provider credentialing, payer enrollment, and delegated credentialing.
• Design and implement process improvements to enhance accuracy and operational efficiency.
• Establish and manage delegated credentialing processes in compliance with NCQA and CMS standards.
• Partner with Finance and Operations to analyze trends and prevent revenue leakage.

Requirements

• Bachelor’s degree in a related field or equivalent experience.
• 5–7 years of progressive experience in provider enrollment, credentialing, or revenue cycle operations.
• 3–5 years of management experience in a healthcare or multi-facility environment.
• Strong knowledge of payer enrollment regulations and provider documentation.
• Proficiency in Microsoft Office (Excel, Word, PowerPoint, Outlook).

Nice to have

• 2–4 years of delegated credentialing experience.
• Healthcare certifications such as HFMA, MGMA, or LEAN.

Culture & Benefits

• Full remote work arrangement.
• Day shift schedule.
• Comprehensive benefits effective from day one.
• Competitive pay.
• Mission-driven team environment.