Credentialing Specialist

Glycare•Jacksonville, FL

2d•Onsite

About The Position

GlyCare is a hospital-based, consultative inpatient diabetes management service. Our Nurse Practitioners and Endocrinologists provide evidence-based glycemic management for non-ICU hospitalized patients, helping improve outcomes and standardize care. We partner directly with hospitals—there are no outpatient clinics or traditional practice settings—and are rapidly expanding across multiple states. Join a rapidly growing, hospital-based clinical program. Support expansion into new states and markets. Contribute directly to provider readiness and operational success. Help build scalable enrollment processes. GlyCare is seeking an experienced Payer Enrollment Specialist to manage provider and group enrollment across multiple states. The ideal candidate is highly organized and able to independently navigate payer requirements, manage multiple deadlines, resolve application issues, and develop clear SOPs. This role requires a critical and proactive thinker who can anticipate potential issues and provide accurate, timely updates to leadership.

Requirements

At least two years of payer or provider enrollment experience
Experience enrolling individual providers and groups with Medicare, Medicaid, and commercial payers
Working knowledge of CAQH, NPPES, PECOS, state Medicaid portals, and other online enrollment platforms
Experience with online workflow and task-management systems, such as Monday.com
Ability to research payer requirements and develop clear SOPs and workflows
Highly organized, with the ability to manage multiple applications, deadlines, and priorities
Critical and proactive thinker who can identify problems and develop practical solutions
Strong follow-up, problem-solving, research, and communication skills
Ability to provide concise and accurate updates to leadership
High attention to detail, accountability, and ability to work independently
Proficiency with Microsoft Excel and shared document systems

Nice To Haves

Multi-state enrollment experience preferred
Experience supporting a hospital-based or multi-location medical group preferred

Responsibilities

Manage provider and group enrollment with Medicare, Medicaid, and commercial payers
Complete initial enrollments, provider additions, demographic updates, revalidations, group affiliations, and other required maintenance
Maintain accurate provider information in CAQH, NPPES, PECOS, and state Medicaid portals
Track applications from submission through approval and effective-date confirmation
Complete timely and consistent follow-up on all submitted applications
Resolve outstanding requirements, processing delays, and application discrepancies
Communicate approvals, effective dates, delays, and enrollment risks to leadership and appropriate internal teams
Research state- and payer-specific enrollment requirements, timelines, and dependencies
Develop and maintain SOPs, workflows, checklists, and training materials
Create repeatable processes that support new providers, locations, and markets
Identify inefficiencies and recommend practical process improvements
Track applications, effective dates, revalidations, expirations, and follow-up deadlines
Use online credentialing platforms and task trackers, including Monday.com, to manage progress and outstanding items
Document submissions, payer contacts, approvals, and follow-up activity
Review applications and supporting documentation for completeness and accuracy
Monitor payer-required licenses, certifications, malpractice coverage, and other provider documents
Maintain organized, accurate, and audit-ready electronic files
Coordinate with billing, operations, clinical leadership, providers, and other internal stakeholders
Provide leadership with clear updates on application status, outstanding items, expected effective dates, and potential delays
Support provider onboarding by identifying and collecting payer-required information
Escalate risks early with a clear summary of the issue and planned next steps
Serve as an internal resource for payer enrollment questions