Credentialing & Payor Enrollment Supervisor

Ensemble Health Partners • Work at Home - Ohio - Other, OH

1d • $69,400 - $104,100 • Remote

About The Position

The Credentialing & Payor Enrollment Supervisor leads daily credentialing and payor enrollment operations to support timely provider readiness, payer participation, and compliance with regulatory, accreditation, payer, and internal requirements. The role supervises credentialing specialists, monitors operational performance, ensures accurate provider data and documentation, and supports credentialing, recredentialing, enrollment, revalidation, maintenance, delegated roster, and related payer activities. The Supervisor serves as an escalation point for complex or high-risk items and supports continuous improvement in quality, timeliness, and audit readiness.

The position oversees credentialing and payor enrollment workflows for providers, groups, and facilities. It manages work queues and priorities, supervises team performance, monitors quality and compliance, and collaborates with internal stakeholders, clients, and payer representatives. The Supervisor promotes process consistency, maintains audit-ready documentation, and ensures adherence to regulatory, accreditation, payer, delegated credentialing, and internal policy requirements.

This is a remote position, with travel to and work onsite at client, temporary, or corporate office locations as business needs require. The role is limited to individuals who reside and are authorized to work within the United States. The advertised annual pay range is $69,400–$104,100, depending on experience.

Requirements

• Bachelor’s degree in Healthcare Administration, Business Administration, Revenue Cycle Management, or a related field; an equivalent combination of education and experience may be considered.
• At least 5 years of provider credentialing, payor enrollment, or closely related healthcare operations experience.
• At least 2 years of direct leadership, supervisory, or team lead experience.
• Experience with commercial and governmental payer credentialing or enrollment processes.
• Experience using provider credentialing, enrollment, or provider data management systems.
• Demonstrated knowledge of healthcare regulatory, accreditation, payer, or delegated credentialing requirements affecting provider credentialing and enrollment operations.
• Knowledge of provider credentialing, recredentialing, payor enrollment, and provider lifecycle processes; governmental and commercial payer requirements; provider data and documentation; delegated credentialing and roster processes; and operational performance, quality assurance, audit readiness, and compliance controls.
• Skills in team leadership, coaching, employee development, workflow coordination, issue resolution, risk identification, escalation management, data analysis, reporting, quality assurance, documentation review, audit support, cross-functional communication, stakeholder coordination, and follow-through.
• Ability to prioritize multiple demands in a fast-paced, deadline-driven environment; interpret complex requirements; build effective relationships; communicate clearly across organizational levels; identify risks and support corrective action or process improvement; and drive accountability for quality, compliance, timeliness, audit readiness, and service performance.
• Must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.
• Must reside and be authorized to work in the United States.

Nice To Haves

• Experience supporting delegated credentialing environments.
• Experience working with NCQA standards and accreditation requirements.
• Experience supporting multi-state provider, group, or facility credentialing and payor enrollment activities.
• Experience leading credentialing or payor enrollment operations in a centralized shared services environment.
• Professional certification related to credentialing, provider enrollment, healthcare operations, or revenue cycle management.

Responsibilities

• Supervise daily provider credentialing and payor enrollment operations and workflow activities.
• Lead and develop Provider Credentialing Specialists through coaching, training, performance management, and workload coordination.
• Oversee credentialing, recredentialing, initial enrollment, revalidation, maintenance, termination, group enrollment, facility enrollment, and ownership change activities.
• Monitor credentialing and enrollment status, aging reports, work queues, payer follow-up, and application progress to support timely completion.
• Investigate and resolve complex credentialing, enrollment, payer, data, documentation, and operational escalations.
• Maintain accurate provider credentialing and enrollment information in designated systems and databases.
• Coordinate credentialing and enrollment activities with medical staff, revenue cycle, operations, clients, payer representatives, and other cross-functional partners.
• Ensure compliance with payer requirements, CMS guidelines, NCQA standards, delegated credentialing requirements, applicable regulations, and internal policies.
• Maintain complete, accurate, and audit-ready documentation for credentialing and enrollment activities.
• Perform quality reviews and routine audits to promote accuracy, consistency, compliance, and process improvement.
• Support delegated roster submission, receipt confirmation, payer approval follow-up, and related documentation requirements.
• Analyze operational performance metrics and identify opportunities to improve efficiency, quality, service delivery, and provider readiness outcomes.
• Support implementation of standard work procedures, process improvements, quality controls, and best practices.
• Maintain awareness of regulatory, accreditation, payer, and industry changes affecting credentialing and payor enrollment operations.
• Prepare leadership reports and status updates on operational performance, progress, risks, and escalations.
• Use advanced AI capabilities and manage teams using AI to support process and technological improvements, including exploration, experimentation, and application.

Benefits

• Comprehensive benefits package, including healthcare, time off, retirement, and well-being programs.
• Paid professional certifications relevant to the associate’s field.
• Tuition reimbursement.
• Quarterly and annual incentive programs.
• Career advancement and professional development opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager