Credentialing Manager

Position Summary

The Credentialing Manager serves as the operational partner to credentialing leadership by managing day-to-day credentialing and enrollment activities, team performance, and workflow optimization. This role focuses on improving efficiency, implementing automation, and ensuring timely provider onboarding and compliance.

Position Details

• Location: Northbrook, IL
• Schedule: Full-time, Monday through Friday on-site.
• Compensation: $75,000 - $95,000

Key Responsibilities

• Manage day-to-day credentialing and payer enrollment operations, ensuring timely completion of provider applications and renewals.
• Monitor department productivity, application status, enrollment aging, and onboarding timelines.
• Develop and maintain operational reports, dashboards, and KPI tracking tools.
• Standardize credentialing processes, maintain SOPs, and identify opportunities to reduce delays and improve efficiency.
• Train, mentor, and support credentialing staff while ensuring adherence to payer and regulatory requirements.
• Coordinate escalations with payers, providers, and internal stakeholders to resolve enrollment issues.
• Serve as the operational partner to the Director by leading process improvements and executing department initiatives.

AI & Automation Responsibilities

• Automate provider status updates, enrollment tracking, and stakeholder communications.
• Implement automated alerts for expiring licenses, certifications, malpractice coverage, and payer renewals.
• Develop AI-assisted dashboards that monitor application progress, aging, and team productivity.
• Utilize automation tools to reduce manual document collection, tracking, and reporting activities.

Requirements

• Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, or related field preferred.
• Minimum 5 years of provider credentialing and payer enrollment experience.
• Strong knowledge of CAQH, Medicare, Medicaid, commercial payer enrollment, and provider licensing requirements.
• Experience managing credentialing workflows, productivity metrics, and provider onboarding timelines.
• Proficiency with credentialing software, reporting tools, and document management systems.

Benefits

• Health
• Dental
• Vision
• 401k & Match
• Paid time off