Director of Credentialing, Licensing & Payer Enrollment
About The Position
The Director of Provider Credentialing, Licensing & Payer Enrollment is responsible for the strategic oversight, execution, and continuous improvement of all provider credentialing, re-credentialing, payer enrollment, contracting coordination, and licensure activities across all AnswersNow business entities. This is a high-visibility leadership role critical to enabling timely provider onboarding, multi-state expansion, and revenue generation. The Director ensures that providers and groups are credentialed, contracted, and licensed accurately and on time so that services may be delivered, billed, and reimbursed without delay. This role leads the credentialing team, manages external vendors, partners cross-functionally with RCM, growth, operations, scheduling, and technology teams, and delivers clear, data-driven reporting to executive leadership.
Requirements
- Bachelor’s degree or equivalent healthcare experience in credentialing, provider enrollment, or contracts administration
- 3–5+ years of progressive experience in provider credentialing, payer enrollment, or payor relations within an insurance company, hospital system, or large provider group
- Demonstrated experience leading teams and/or managing vendors
- Strong working knowledge of healthcare reimbursement, managed care contracting, and payer enrollment processes
- Proficiency with credentialing systems, payer portals, and reporting tools
Nice To Haves
- Experience supporting multi-state provider organizations or rapid geographic expansion
- Experience with telehealth services as it relates to cross-state licensure/credentialing
- Strong background in Medicaid credentialing and state-specific licensing requirements
- Experience in delegated credentialing environments
- Experience working in high-growth, technology-enabled healthcare organizations
- High level of organization, attention to detail, and ability to manage competing priorities
- Familiarity with workflow automation, system integrations, or custom internal platforms
Responsibilities
- Lead, coach, and develop the Credentialing & Licensing team
- Design and implement scalable credentialing and enrollment workflows
- Partner closely with Provider Onboarding and Growth teams to ensure all required documentation is collected promptly and credentialing is initiated without delay
- Oversee the review and validation of practitioner applications
- Own payer enrollment and credentialing activities and coordinate payer contracting submission
- Own credentialing systems, vendors, and tools including CAQH, NPPES, payer portals, and internal platforms
- Provide regular executive-level updates on credentialing performance, priorities, and operational risks
Benefits
- Fully remote – work from anywhere in the U.S.
- Flexible hours with an async-friendly team culture
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What This Job Offers
Job Type
Full-time
Career Level
Director
