Confidential Healthcare Technology & Services Organization
Remote Opportunity
Immediate Hire
Join a PE-Backed Healthcare Organization Experiencing Significant Growth
With over three decades of success, this award-winning healthcare services and technology organization is entering an exciting new phase of expansion backed by private equity investment, long-term client partnerships, and continued nationwide growth.
This is not a basic credentialing role.
We are seeking an experienced healthcare operations leader to oversee provider enrollment, credentialing, payer enrollment, and licensing operations supporting fast-growing RCM and ACO programs.
The ideal candidate brings strong operational leadership, healthcare compliance expertise, team management experience, and the ability to improve processes, metrics, and overall delivery performance.
Key Responsibilities:
- Lead provider credentialing, enrollment, recredentialing, and licensing operations.
- Manage payer enrollment processes including Medicare, Medicaid, and commercial plans.
- Oversee credentialing workflows supporting RCM and ACO programs.
- Lead and support onshore and offshore credentialing teams.
- Monitor KPIs, SLAs, turnaround times, and operational performance.
- Ensure compliance with CMS, NCQA, payer, and regulatory requirements.
- Partner with internal teams and clients to support provider onboarding and operational readiness.
- Resolve enrollment issues, delays, denials, and compliance concerns.
- Deliver operational reporting and process improvement initiatives.
- Participate in client meetings and leadership discussions.
Qualifications:
- 5+ years of healthcare credentialing and provider enrollment experience.
- Leadership experience managing credentialing or healthcare operations teams.
- Strong knowledge of payer enrollment, provider licensing, and credentialing workflows.
- Experience within RCM, ACO, managed care, provider networks, or healthcare services environments.
- Ability to manage multiple priorities in a fast-paced environment.
- Strong communication, organizational, and problem-solving skills.
- Experience working with offshore or distributed teams is a plus.
Preferred Keywords / Experience:
- Credentialing.
- Provider Enrollment.
- CAQH.
- PECOS.
- CMS.
- RCM.
- ACO.
- Managed Care.
- Licensing.
- Recredentialing.
- Healthcare Operations.
Excellent opportunity to join a very stable, growth-oriented healthcare organization where operational leadership, process improvement, and client impact are highly valued.
Qualified candidates will be contacted ASAP.