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Credentialing Provider Enrollment Manager Jobs (NOW HIRING)

Charlie Health

Credentialing Manager

New York, NY · Remote

About the Role The Credentialing & Provider Enrollment Manager will lead Charlie Health's credentialing function and the team of specialists responsible for health plan enrollment across Medicaid and ...

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Credentialing Provider Enrollment Manager information

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How much do credentialing provider enrollment manager jobs pay per year?

As of Aug 10, 2026, the average yearly pay for credentialing provider enrollment manager in the United States is $85,031.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,000.00 and $94,500.00 per year, depending on experience, location, and employer.

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.
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Credentialing Provider Enrollment Manager jobs near you
Infographic showing various Credentialing Provider Enrollment Manager job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $85,031 per year, or $40.9 per hour.

Credentialing/Provider Enrollment Specialist | Managed Care & Corporate Development

UF Health

Gainesville, FL • Hybrid

Full-time

Re-posted 10 days ago

Job description

Overview

Supporting the Network Behind Exceptional Care. 

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???? Location: Gainesville, FL 
???? FTE: Full-Time (1.0 FTE)
⏰ Schedule: Monday – Friday - 8:00 am to 5:00 pm

Verifies and authenticates the credentials of healthcare professionals to ensure compliance with regulatory standards. Coordinates with medical staff and external agencies to collect and review necessary documentation, maintaining accurate credentialing records, and monitoring expiration dates for timely renewals. Supports audit and accreditation processes by preparing reports and documentation, communicates credentialing requirements to stakeholders, and assists the credentialing committee with meeting coordination. Requires resolving discrepancies and following up on incomplete credentialing information to maintain data integrity and compliance.

This position works collaboratively with Managed Care, Credentialing, Revenue Cycle, Medical Staff, Operations, and IT teams to support provider onboarding, enrollment maintenance, payor reporting, and operational workflow coordination across the health system.


Responsibilities

Key Responsibilities

  • Verifies and authenticates credentials of healthcare professionals.
  • Coordinates with medical staff and external agencies for documentation collection and review.
  • Maintains accurate credentialing records and monitors expiration dates.
  • Supports audit and accreditation processes with reports and documentation.
  • Communicates credentialing requirements to stakeholders.
  • Assists the credentialing committee with meeting coordination.
  • Resolves discrepancies and follows up on incomplete credentialing information.

Qualifications
Minimum Qualifications
  • Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, or a related field required; equivalent work experience may be considered in lieu of education
    • 3+ years of experience in healthcare credentialing, provider enrollment, or medical staff services.
    • Knowledge of healthcare regulatory requirements, credentialing standards, and accreditation processes.
    • Experience managing credentialing documentation, primary source verification, and provider renewal processes.
    • Strong organizational, communication, and record management skills.
    • Ability to coordinate effectively with medical staff, providers, licensing boards, payers, and external agencies.
     
Preferred Qualifications
  • Experience with delegated provider rosters, provider onboarding, and enrollment maintenance workflows
  • Familiarity with PECOS, NPPES, Medicaid portals, Medicare enrollment processes, and commercial payor systems
  • Knowledge of provider enrollment, delegated credentialing, provider directory maintenance, and payor loading processes
  • Experience validating provider demographics, NPIs, TINs, practice locations, specialties, taxonomy codes, and participation records
  • Familiarity with CMS, AHCA, NCQA, and delegated credentialing requirements
  • Experience working within a large multi-site health system, academic medical center, or managed care environment
  • Experience with credentialing or enrollment systems such as CredentialStream, MD-Staff, or related platforms
     
     

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