Credentialing Consultant Jobs (NOW HIRING)

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Full Time Corporate Corporate, Oak Brook, IL, US

2 days ago Requisition ID: 1186

Salary Range: $100,000.00 To $115,000.00 Annually

Credentialing, Manager

Why NANI?

NANI is the nation’s largest Nephrology practice. We have provided excellence in specialty kidney care for over 50 years. NANI’s nephrology practices are primarily operated in northern Illinois and throughout northern and central Indiana, with additional locations in New Jersey. NANI’s scope of care and services includes difficult-to-control hypertension, kidney disease, kidney injury, kidney transplant, and related services, as well as groundbreaking and lifesaving clinical research and consulting services.

Join Our Team!

Job Title: Credentialing, Manager

Location: In-office (open to Hybrid work schedule)

Department: Revenue Cycle / Credentialing

Reports To: Director of Revenue Cycle

FLSA Status: Exempt

Position Summary:

We are seeking an experienced and detail-oriented Senior Manager of Credentialing to lead and oversee all credentialing operations, including payer enrollment, Medicare/Medicaid revalidations, payer roster submissions, contract management, EFT/ERA setup, and portal administration. This role is instrumental in maintaining provider compliance and payer alignment across a complex, multi-entity environment.

The ideal candidate brings deep expertise in credentialing and payer engagement, strong technological acumen, and hands‑on experience in revenue cycle management. Prior experience working with Physician-Hospital Organizations (PHOs) is highly desirable.

• Direct and manage all aspects of provider and facility credentialing, recredentialing, and payer enrollment—including Medicare and Medicaid revalidations—ensuring timely and accurate submissions.
• Maintain a robust calendar and tracking system to manage credentialing timelines, expirations, and compliance deadlines.
• Lead the timely submission of payer rosters, ensuring alignment with current provider data and reducing claim denials.
• Oversee payer contract enrollment processes from initial application through approval, including effective communication and follow-up with payer representatives.
• Administer and optimize EFT/ERA enrollment with all commercial and governmental payers.
• Manage access and usage of payer and credentialing portals, ensuring data accuracy and appropriate user access across teams.
• Serve as a liaison with Physician-Hospital Organizations (PHOs) and partner entities for credentialing alignment, shared rosters, and contract consistency.
• Champion the use of technology to organize, store, and monitor credentialing data, leveraging tools such as credentialing databases, cloud platforms, and dashboard reporting systems.
• Collaborate with internal teams including Revenue Cycle, Compliance, Legal, and Operations to ensure provider data integrity and readiness.
• Provide regular reporting and status updates to leadership on credentialing metrics, compliance risks, and opportunities for process improvement.
• Recruit, develop, and supervise a credentialing team focused on efficiency, accuracy, and service excellence.

• Bachelor’s degree in healthcare administration, Business, or related field (Master’s preferred).
• 5–7+ years of experience in medical credentialing, including payer enrollment, revalidations, EFT/ERA setup, and roster management.
• Hands‑on experience with Medicare and Medicaid enrollment and revalidation processes.
• Proven background working in or closely with Revenue Cycle Management teams.
• Experience working within or alongside Physician‑Hospital Organizations (PHOs).
• Strong proficiency with credentialing software (e.g., CAQH, PECOS), payer portals, and cloud‑based organizational tools.
• Detail‑oriented, deadline‑driven, and adept at managing large datasets with accuracy.
• Excellent communication and leadership skills; able to interact professionally with providers, payers, and executive teams.

• Multi‑state credentialing and high‑volume provider group experience.
• Familiarity with value‑based care models and PHO collaborative frameworks.
• Project management or process improvement experience.