Credentialing Manager

The Remedy•Vadnais Heights, MN

About The Position

The Credentialing Manager is responsible for leading and executing all aspects of provider credentialing, payer enrollment, and payer contracting. This role serves as both a strategic leader and a hands-on contributor, ensuring credentialing operations are efficient, compliant, and aligned with provider onboarding timelines. The ideal candidate brings prior experience as a credentialing lead or manager and has deep expertise in resolving complex enrollment and contracting issues, driving timelines, and supporting organizational growth.

Requirements

5+ years of credentialing experience, including experience 2+ years in a supervisory or management role.
Direct experience with payer enrollment and payer contracting
Strong working knowledge of credentialing processes, compliance requirements, and payer systems
Demonstrated ability to manage timelines and resolve complex credentialing and enrollment issues
Experience leading or mentoring team members
Hands-on, roll-up-your-sleeves leadership approach
Strong problem-solving and critical thinking skills
Ability to manage competing priorities and tight timelines
High attention to detail and accuracy
Effective cross-functional communication
All candidates must be legally authorized to work in the United States. The company does not currently sponsor employment visas.

Nice To Haves

Experience credentialing providers in Minnesota, South Dakota, and Wisconsin
Multi-state credentialing experience
Experience in a high-growth or multi-site healthcare organization
Familiarity with CAQH and credentialing/enrollment platforms

Responsibilities

Lead, mentor, and support the credentialing team while maintaining a hands-on role in daily operations
Act as a working manager, stepping in to complete credentialing, enrollment, and contracting tasks as needed
Set clear expectations, monitor performance, and ensure accountability to timelines
Oversee and actively manage end-to-end provider credentialing and recredentialing processes
Lead payer enrollment activities including initial enrollments, revalidations, updates, and terminations
Ensure compliance with all payer, state, and federal requirements
Manage and support payer contracting processes, including applications, follow-up, and execution
Track and drive contract timelines to ensure providers are in-network as quickly as possible
Partner with leadership on payer participation and network strategy
Develop and manage credentialing and enrollment timelines aligned with provider start dates
Identify bottlenecks and implement process improvements to increase efficiency and reduce delays
Build tracking and reporting mechanisms to provide visibility into credentialing status and risks
Serve as the escalation point for complex or stalled credentialing, enrollment, or contracting issues
Proactively identify risks and implement solutions to prevent delays
Build and leverage payer relationships to resolve issues effectively