Senior Manager, Contracting & Credentialing

Dreem Health•Olive, IN

2d•$80,000 - $90,000

About The Position

The Senior Manager of Contracting & Credentialing is a strategic and operational leader responsible for overseeing provider credentialing, provider licensing, payer contracting, and network expansion across multiple states for a growing telehealth sleep medicine organization. This role requires deep expertise in multi-state credentialing, payer enrollment, government programs (Medicare/TriCare), and third-party vendor management, with a strong understanding of reimbursement and compliance. This role is critical to enabling scalable growth, payer access, and regulatory compliance in a complex, multi-state telehealth environment. The Senior Manager will directly influence provider onboarding speed, payer coverage, revenue integrity and long-term network strategy with direction from the Direction of Managed Care Contracting. The ideal candidate is CPC-certified, highly organized, data-driven, and experienced in scaling provider networks while maintaining compliance with federal, state, and payer requirements.

Requirements

CPC Certification (required)
7+ years of experience in provider credentialing, payer contracting, or provider enrollment
Proven experience with multi-state credentialing and telehealth operations
Strong knowledge of Medicare/PECOS, commercial payers, and government programs
Experience managing third-party credentialing and contracting vendors
Strong understanding of provider reimbursement and fee schedules
Exceptional organizational, communication, and stakeholder-management skills

Nice To Haves

Familiarity with sleep medicine, DME, or specialty care preferred
Experience in a telehealth or virtual care environment
Knowledge of AASM, ACHC, or similar accreditation standards
Experience supporting API-driven or data-centralized credentialing systems
Exposure to payer analytics, market expansion strategy, or value-based care

Responsibilities

Lead end-to-end provider credentialing, provider licensing and recredentialing for MDs and NPs, and any additional allied clinicians across multiple states
Oversee CAQH, PECOS, Medicare, and commercial payer enrollment
Ensure compliance with state licensure, scope of practice, supervision, and collaborative practice requirements
Maintain credentialing records, expiration tracking, and audit-ready documentation
Manage credentialing/licensing timelines to support rapid provider onboarding and market expansion
Lead payer contracting strategy across commercial, Medicare Advantage, and government payers with direction from Director of Managed Care Contracting
Negotiate and evaluate fee schedules, reimbursement rates, and contract terms
Support payer expansion strategy aligned with business growth, market demand, and clinical capabilities
Coordinate contracting for multi-entity, multi-TIN structures
Partner with leadership to assess network adequacy, access, and financial impact
Oversee Medicare enrollment and compliance (PECOS, reassignment, revalidation)
Support state-specific government program participation
Ensure adherence to CMS, No Surprises Act, and payer regulatory requirements
Collaborate with Compliance to mitigate credentialing and contracting risk
Manage relationships with credentialing and contracting vendors
Define SLAs, workflows, and performance expectations
Audit vendor work for accuracy, timeliness, and compliance
Serve as escalation point for complex credentialing or payer issues
Partner closely with Compliance, Legal, Finance, Product, Clinical Leadership and Sales/Marketing/Business Development
Support product and dev teams with credentialing and payer data requirements (APIs, system builds)
Provide reporting and dashboards on credentialing status, payer growth, and risk areas
Prepare materials for board, compliance committee, and executive review