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Credentialing Manager Jobs in Worcester, MA (NOW HIRING)

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Medical Credentialing Specialist

Smithfield, RI · On-site

$19 - $21/hr

Grey Ledge Medical Management, a third-party medical billing and credentialing company, is seeking a full-time (40 hours per week) team member to join our growing organization. This position is ...

Comprehensive Practice Managem

Be Seen First

Medical Credentialing Specialist

Smithfield, RI · On-site

$19 - $21/hr

Grey Ledge Medical Management, a third-party medical billing and credentialing company, is seeking a full-time (40 hours per week) team member to join our growing organization. This position is ...

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All JobsCredentialing JobsCredentialing Manager JobsCredentialing Manager Jobs in Worcester, MA

Credentialing Manager information

See Worcester, MA salary details

$43.4K

$84.8K

$131.2K

How much do credentialing manager jobs pay per year?

As of Sep 2, 2026, the average yearly pay for credentialing manager in Worcester, MA is $84,845.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,900.00 and $94,300.00 per year, depending on experience, location, and employer.

What is a credentialing manager?

Credentialing Managers are professionals responsible for overseeing the process of verifying the qualifications, licenses, and background of healthcare providers before they are allowed to work with patients or participate in insurance networks. They ensure that all providers meet regulatory and organizational standards, and maintain up-to-date records for compliance purposes. Credentialing Managers often work in hospitals, healthcare organizations, or insurance companies, collaborating with medical staff, administrators, and external agencies to manage and streamline the credentialing process.

What does a credentialing manager do?

A credentialing manager monitors the credential status of employees and ensuring they are recertified when necessary. As a credentialing manager, your job duties involve maintaining a database of employee certifications and renewal dates, confirming that employee credentials match the requirements of their job, and helping employees renew their credentials on time by finding test dates and locations. Credentialing managers are most commonly found in the health care industry. Qualifications to become a medical credentialing manager include a bachelor’s degree in human resources, business, or a related field, and industry experience.

What are the key skills and qualifications needed to thrive as a credentialing manager?

To thrive as a Credentialing Manager, you need thorough knowledge of healthcare credentialing processes, compliance standards, and experience with provider enrollment, often supported by a bachelor's degree in healthcare administration or a related field. Familiarity with credentialing software systems like CACTUS or Verity, and understanding of regulatory requirements such as NCQA or The Joint Commission, are typically expected. Attention to detail, strong organizational skills, and effective communication are standout soft skills for this position. These competencies ensure accurate and efficient management of provider credentials, minimize compliance risks, and maintain quality standards within healthcare organizations.

What are some common challenges a credentialing manager faces when maintaining compliance with changing regulations?

Credentialing Managers often encounter the challenge of staying updated with frequently changing industry regulations and payer requirements, which can vary by state and organization. Ensuring that all provider files are consistently accurate and compliant requires diligent monitoring, regular audits, and ongoing staff training. Additionally, coordinating with multiple departments and external agencies to gather necessary documentation while meeting tight deadlines can be demanding. Proactively implementing process improvements and leveraging credentialing software can help manage these complexities effectively.

What is the difference between Credentialing Manager vs Credentialing Specialist?

AspectCredentialing ManagerCredentialing Specialist
ResponsibilitiesOversees entire credentialing process, manages teams, develops policiesPerforms credentialing tasks, verifies credentials, maintains records
Required CredentialsTypically requires experience in healthcare administration, certifications like Certified Provider Credentialing Specialist (CPCS)Often requires similar certifications, entry to mid-level experience
Work EnvironmentManagement level, strategic planning, team supervisionOperational, detail-oriented, administrative tasks
Industry UsageUsed across healthcare organizations, hospitals, clinicsCommonly found in healthcare facilities, physician practices

The Credentialing Manager focuses on overseeing the entire credentialing process, managing teams, and developing policies, while the Credentialing Specialist handles day-to-day credential verification and record maintenance. Both roles require relevant certifications and healthcare industry experience, but the manager role involves more strategic oversight.

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Credentialing Manager jobs near you
Infographic showing various Credentialing Manager job openings in Worcester, MA as of August 2026, with employment types broken down into 100% Full Time. Highlights an 77% In-person, and 23% Remote job distribution, with an average salary of $84,822 per year, or $40.8 per hour.

Credentialing Specialist/Coordinator

Family Health Center

Worcester, MA • On-site

$26 - $28/hr

Part-time

Posted 28 days ago

Job description


This position is remote and part-time 20 hours per week and must reside in Massachusetts


Description:

The Credentialing Specialist/Coordinator is responsible for maintaining active status for all providers by successfully completing initial and subsequent Re‐Appointment and Re‐Credentialing packages as required by the Health Center and for our admitting hospital (UMass), our commercial payers, Medicare and Medicaid.


Responsibilities:

Provider OnBoarding (Privileging/Credentialing)

 

  • Initial Contact/Support to Provider’s with Privileging & Credentialing process at acceptance of employment
  • Initiate Provider Hospital Credentialing for Physicians, collaborate w/UMass to maintain Physician Hospital Appointments
  • Maintain internal provider ID’’s roster to ensure all information for Provider’s is accurate and logins is available (NPI/PECOS access)
  • Complete/Provide support to providers in Applying for and renewing provider licenses; Professional, DEA, Controlled Substance, and any other required supporting documentation to practice medicine.
  • Perform all Primary Source Verifications as required by CMS/HRSA/Joint Commission/NCQA for all Health Care Professionals at initial and Re‐Appointments of all LIP’s.
  • Facilitate/Support providers in signing up and/or obtaining compliance trainings, CME’s, Life Support Trainings when due
  • Re‐Credential providers as required for both the Health Center and for UMass
  • Board‐Provider List
  • Board Letters
Credentialing Compliance:
  • Maintain accurate provider credentialing profiles in (Cactus) Cred software.
  • Track and Report Monthly on all Credentialing Expirables
Provider Health Plan Enrollment (Revenue Cycle):

 Complete revalidation requests issued by both MassHealth and PECOS for all providers.

  • Complete credentialing applications to enroll providers to commercial payers, Medicare, and Medicaid
  • Track/Report Provider enrollment progress 
  • Initiate and Maintain each provider’s CAQH database file timely and according to the schedule published by CMS
  • Complete re‐credentialing applications for commercial payers
  • Work closely with the Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing 
  • Create/Maintain accurate provider profiles on online profiles in CAQH, PECOS, NPPES, MassHealth/C3 and CMS databases
  • Other duties as assigned

 Knowledge, Skills and Abilities:

  • Knowledge of provider Credentialing & Provider Enrollment and its direct impact on the practice’s revenue cycle
  • Excellent computer skills including Excel, Word, and Internet navigation for State, Federal sites and healthplan searches
  • Detail oriented with above average organizational skills, and time management
  • Plans and prioritizes to meet deadlines
  • Excellent customer service skills; communicates clearly, effectively and professionally
Education and Experience:
  • High School Diploma, GED, Associates /Bachelors degree
  • 2 years credentialing experience preferred
  • 2 years experience in a medical practice business office role required



Monday-Friday, hours and schedule to be discussed with the hiring manager.