Credentialing & Enrollment Manager

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🐊 Florida – Remote

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

🗽 New York – Remote

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

+4 more states

🐊 Florida – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🔔 Pennsylvania – Remote 🎸 Tennessee – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Steadfast Health

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Healthcare Insurance • Substance Abuse Treatment • Mental Health

Steadfast Health is dedicated to providing compassionate care and facilitating lasting recovery for individuals struggling with substance use disorders (SUD). The company offers a comprehensive range of services that include accessible treatment options, such as outpatient consultations, same-day virtual appointments, and walk-in services. With a patient-centered and evidence-based approach, Steadfast Health aims to support individuals on their unique recovery journeys through medication management, behavioral therapy, and peer recovery support, addressing both substance use and any accompanying medical or psychiatric needs. Their commitment to long-term care coordination ensures that patients receive consistent support throughout their recovery, reducing disruptions and fostering a healing environment.

1 - 10 employees

⚕️ Healthcare Insurance

📋 Description

• Manage all provider credentialing and re-credentialing activities with commercial payers, Medicaid, and Medicare. • Prepare and submit accurate and complete credentialing applications for behavioral health and medical providers. • Maintain up-to-date provider rosters and ensure timely updates with payers. • Track and monitor credentialing application status, proactively resolving delays or issues. • Oversee the process of credentialing providers with hospital and facility partners to support our inpatient consult service line. • Collaborate with hospital medical staff offices to ensure provider files meet facility requirements. • Oversee the process of credentialing support team members who need hospital privileges. • Manage and track all provider licenses needed for provider to perform services across multiple states. • Support providers in obtaining new state licenses as Steadfast Health expands its footprint. • Ensure all credentials, certificates, and licenses are current and compliant with federal, state, and payer regulations. • Develop and maintain standardized credentialing policies, procedures, and workflows. • Implement systems (such as CAQH, credentialing databases, or software tools) to streamline credentialing operations. • Maintain credentialing files in accordance with NCQA, URAC, and other regulatory standards. • Generate regular reports on credentialing status, expirations, and compliance risks for leadership review.

🎯 Requirements

• 3–5+ years of experience in provider credentialing and enrollment with commercial and government payers. • Strong understanding of healthcare compliance, payer requirements, and credentialing standards. • Strong understanding of CAQH and payer portals for initial enrollments as well as provider adds. • Experience managing provider licensure and DEA registrations across multiple states. • Excellent attention to detail, organizational skills, and ability to manage multiple priorities. • Strong written and verbal communication skills; ability to communicate effectively with internal and external stakeholders. • Preferred: Experience with behavioral health credentialing, including BH-specific payer requirements. • Familiarity with hospital medical staff credentialing and privileging processes. • Prior experience in a multi-state or multi-site healthcare organization. • CPCS or CPMSM certification (NAMSS) preferred but not required.

🏖️ Benefits

• Healthcare Coverage: Medical, dental, and vision insurance, with the company contributing 60% of the premium on your behalf. • Time Off: Flexible time off with generous PTO, floating paid holidays, and paid volunteer days • Re-Fuel Days: 4 additional paid days off per year for mental health, rest, or continuing education (CEU) activities. • Employee Assistance Program (EAP): Free, confidential access to therapist sessions, legal guidance, financial resources, health coaching, and more - to support your overall well-being. • 401K Match up to 5% • 100% employer-paid short-term and long-term disability and employer-sponsored life insurance • Additional Benefits: Rightway Health Concierge, PerkSpot discount program, SoFi student loan interest rate discount, and one year of free pet telehealth through Pawp. • An opportunity to get in at the ground level and shape how we grow!