Credentialing Manager/Director

Job not on LinkedIn

September 28

🐊 Florida – Remote

Although this job is listed in Florida, this company may be open to hiring remote in other states.

⏰ Full Time

🔴 Lead

👔 Director

Apply Now

Receive Emails with Similar Jobs

Integrated Dermatology

WebsiteLinkedInAll Job Openings

Healthcare Insurance

Integrated Dermatology is the largest independent dermatology practice in the United States, specializing in acquiring dermatology practices while allowing dermatologists to retain full operational autonomy. The company offers comprehensive support for the administrative functions of medical practices, including areas such as accounting, human resources, and billing. This enables partner dermatologists to focus primarily on patient care. Integrated Dermatology also provides career opportunities for dermatologists looking to join an established network, offering paths to become partners while ensuring autonomy and control over medical and operational decisions.

501 - 1000 employees

Founded 2004

⚕️ Healthcare Insurance

📋 Description

• 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

🎯 Requirements

• Bachelor’s degree required in healthcare administration, business, or related field • Minimum 5 years of experience in non-delegated healthcare credentialing and payer enrollment, with at least 2 years in a leadership capacity • Deep understanding of credentialing standards, payer enrollment protocols, and federal/state regulatory requirements • Hands-on experience with PECOS, CAQH, NPPES, Availity, and other credentialing/enrollment platforms • Technically proficient with Microsoft Office and credentialing management systems (e.g., Verity, Medallion, Modio, or similar) • Proven ability to manage confidential and sensitive information with discretion

🏖️ Benefits

• All your information will be kept confidential according to EEO guidelines.