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Credentialing Provider Enrollment Manager Jobs in Indiana

HHC

Provider Relations Analyst

Indianapolis, IN

Utilizes and applies effective data management principles to ensure that reports and analysis are ... Supports the Provider Relations, Delegated Credentialing, Enrollment and Claims Administration ...

Orthoindy

Credentialing Coordinator

Indianapolis, IN · On-site

Works with other members of the credentialing office to manage the electronic credentialing software platform. * Answers questions, assists with issues that arise and provides detailed information on ...

OrthoIndy

Credentialing Coordinator

Indianapolis, IN

Works with other members of the credentialing office to manage the electronic credentialing software platform. * Answers questions, assists with issues that arise and provides detailed information on ...

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Credentialing Provider Enrollment Manager information

What is the difference between Credentialing Provider Enrollment Manager vs Credentialing Specialist?

AspectCredentialing Provider Enrollment ManagerCredentialing Specialist
CertificationsOften requires industry certifications like CPCS or CPMSMMay hold certifications such as Certified Provider Credentialing Specialist
Work EnvironmentManages teams, oversees enrollment processes, interacts with payersPerforms credentialing tasks, verifies provider information, processes applications
Employer & Industry UsageUsed in healthcare organizations, insurance companies, and credentialing firmsCommonly employed in healthcare facilities, billing companies, and credentialing departments

The Credentialing Provider Enrollment Manager typically oversees the entire provider enrollment process, managing teams and strategic planning. In contrast, the Credentialing Specialist focuses on executing credentialing tasks and verifying provider credentials. Both roles are essential in healthcare credentialing but differ in scope and responsibilities.

What are some common challenges faced by a credentialing provider enrollment manager, and how can they be addressed?

Credentialing Provider Enrollment Managers often encounter challenges such as managing tight deadlines for provider onboarding, navigating complex payer requirements, and ensuring compliance with ever-changing regulations. Maintaining clear communication with providers and payers, staying updated on industry standards, and implementing robust tracking systems can help address these issues effectively. Regular training for staff and fostering a collaborative team environment are also key strategies for overcoming these challenges and ensuring smooth enrollment processes.

What is a credentialing provider enrollment manager?

A Credentialing Provider Enrollment Manager is a professional responsible for overseeing the process of verifying healthcare providers’ qualifications and enrolling them with insurance payers and government programs. They ensure that all providers meet the necessary standards and maintain compliance with regulatory and organizational requirements. Their role includes managing documentation, coordinating with providers and payers, and staying up to date with changes in credentialing and enrollment policies. This position is essential for healthcare organizations to ensure that providers are authorized to deliver services and receive reimbursement.

What are the key skills and qualifications needed to thrive as a credentialing provider enrollment manager, and why are they important?

To thrive as a Credentialing Provider Enrollment Manager, you need in-depth knowledge of healthcare regulations, credentialing standards, and provider enrollment processes, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with credentialing software (such as CAQH or Verity), database management, and understanding of payer requirements are typically essential. Exceptional organizational skills, attention to detail, and strong communication abilities help in managing complex documentation and facilitating provider relations. These competencies ensure accurate, timely provider onboarding and regulatory compliance, which are critical for uninterrupted patient care and organizational success.
What are the most commonly searched types of Credentialing Provider Enrollment jobs in Indiana? The most popular types of Credentialing Provider Enrollment jobs in Indiana are:
What are popular job titles related to Credentialing Provider Enrollment Manager jobs in Indiana? For Credentialing Provider Enrollment Manager jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Credentialing Provider Enrollment Manager jobs in Indiana look for? The top searched job categories for Credentialing Provider Enrollment Manager jobs in Indiana are:
What cities in Indiana are hiring for Credentialing Provider Enrollment Manager jobs? Cities in Indiana with the most Credentialing Provider Enrollment Manager job openings:
Credentialing Provider Enrollment Manager jobs near you
Infographic showing various Credentialing Provider Enrollment Manager job openings in Indiana as of August 2026, with employment types broken down into 90% Full Time, and 10% Part Time. Highlights an 90% In-person, and 10% Remote job distribution.

Manager Provider Credentialing & Enrollment

Deaconess

Evansville, IN • On-site

Full-time

Posted 6 days ago

Deaconess Health System rating

6.7

Company rating: 6.7 out of 10

Based on 157 frontline employees who took The Breakroom Quiz

533rd of 887 rated healthcare providers

Job description

The Manager of Provider Credentialing & Enrollment is responsible for the operational leadership, oversight, and optimization of Deaconess Health System's provider credentialing verification, provider enrollment, and facility enrollment functions. This position leads teams responsible for primary source verification, provider data integrity, payer enrollment, revalidation, and ongoing monitoring activities that support provider readiness, regulatory compliance, and reimbursement.
The Manager ensures providers and facilities are credentialed, enrolled, and maintained in accordance with applicable regulatory, accreditation, and payer requirements. The position works closely with Medical Staff Services, Revenue Cycle, Managed Care, Physician Recruitment, Practice Operations, Compliance, and Health System leadership to support seamless provider onboarding and uninterrupted reimbursement.
Provider Credentialing Operations
  • Lead provider credentialing activities for physicians, APPs, and other practitioners.
  • Ensure timely and accurate primary source verification.
  • Oversee licensure, board certification, sanctions, exclusions, malpractice, and ongoing monitoring.
  • Maintain audit-ready credentialing records.
  • Monitor KPI reporting for turnaround times and quality metrics.
Provider and Facility Enrollment
  • Lead Medicare, Medicaid, managed care, and governmental payer enrollment activities.
  • Oversee initial enrollments, revalidations, provider updates, ownership changes, and terminations.
  • Ensure providers and facilities are enrolled timely to prevent reimbursement delays.
  • Monitor payer enrollment performance and aging metrics.
Provider Data Management and Integrity
  • Maintain provider demographic, credentialing, and enrollment data across enterprise systems.
  • Support provider data governance initiatives.
  • Collaborate with Revenue Cycle, HR, Information Systems, and Medical Staff Services.
Compliance, Governance, and Audit Support
  • Ensure compliance with CMS, ACHC, NCQA, state regulations, and payer requirements.
  • Support internal and external audits and accreditation reviews.
  • Oversee exclusion screening and sanction monitoring processes.
  • Create, update and enforce credentialing enrollment policies.
Leadership and Team Development
  • Lead and develop credentialing and enrollment staff.
  • Establish and maintain productivity, quality, and service expectations.
  • Drive process improvement, automation, and standardization initiatives.
Qualifications
  • Bachelor's degree required; Master's degree preferred.
  • Five years of credentialing, enrollment, medical staff services, provider operations, or revenue cycle experience.
  • Three years of leadership experience preferred.
  • CPCS, CPMSM, or CPES certification preferred; if not currently certified, must obtain one of these credentials within three years of hire.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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