Sr. Manager of Credentialing and Contracting
On-site · Henderson, Nevada, United States
Job Summary
Senior Manager of Credentialing and Contracting leads credentialing, enrollment, and payer contracting operations across multiple states. Drives Medicare/Medicaid enrollment, payer enrollment through CAQH/PECOS/NPI, and negotiation/terms tracking for payer contracts. Develops SOPs, dashboards, and escalation workflows; ensures timely, compliant provider readiness and accurate billing. Collaborates with leadership across revenue cycle, operations, compliance, finance, and clinical teams to support growth, enrollment, and market expansion.
Required Qualifications
- Bachelor’s degree in healthcare administration, business administration, or a related field preferred; equivalent experience may be considered.
- Minimum of 5–7 years of progressive experience in healthcare credentialing, payer enrollment, payer contracting, provider enrollment, or a closely related function.
- Experience working directly with payer representatives required.
- Experience with Medicare and Medicaid enrollment required.
- Experience supporting payer contract review, payer negotiations, or rate discussions strongly preferred.
- Multi-state healthcare experience strongly preferred.
- CPCS, CPMSM, or similar credentialing certification preferred but not required.
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