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Managed Care Credentialing Jobs (NOW HIRING)

Coordinator, Managed Care, Credentialing Managed Care contributes to Cardinal Health Practice Operations Management oversees the business and administrative operations of a medical practice. Managed ...

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Managed Care Credentialing information

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How much do managed care credentialing jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for managed care credentialing in the United States is $24.36, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $27.64 per hour, depending on experience, location, and employer.

What is managed care credentialing?

Managed care credentialing is the process by which healthcare organizations, such as insurance companies or managed care organizations, verify and evaluate the qualifications of healthcare providers before allowing them to join their network. This includes checking education, licensure, experience, and professional history to ensure providers meet specific standards and regulations. Credentialing helps maintain quality of care and protects patients by ensuring only qualified professionals deliver services within the network.

What are the key skills and qualifications needed to thrive in managed care credentialing?

To excel in Managed Care Credentialing, you need a thorough understanding of healthcare regulations, credentialing standards, and provider enrollment processes, often supported by experience in healthcare administration or a related certification like CPCS. Familiarity with credentialing software, databases, and compliance tracking systems such as CAQH and NCQA standards is typically required. Attention to detail, strong organizational skills, and effective communication help ensure accuracy and timely credentialing of providers. These competencies are crucial for maintaining regulatory compliance, reducing risk, and ensuring smooth operations within healthcare organizations.

What are some common challenges faced by professionals in managed care credentialing, and how can they be addressed?

Professionals in managed care credentialing often encounter challenges such as staying current with frequently changing regulations and payer requirements, keeping up with large volumes of applications, and managing tight deadlines. Effective organization, strong attention to detail, and leveraging credentialing software can help streamline processes and reduce errors. Building strong communication with providers and payers also plays a critical role in resolving issues quickly and ensuring compliance.

What is the difference between Managed Care Credentialing vs Medical Billing Specialist?

AspectManaged Care CredentialingMedical Billing Specialist
Required CredentialsCertifications in healthcare administration, insurance, or related fields; often requires knowledge of payer policiesCertification in medical billing or coding; familiarity with billing software and coding standards
Work EnvironmentHealthcare organizations, insurance companies, or credentialing firmsMedical offices, billing companies, healthcare facilities
Employer & Industry UsageUsed by healthcare providers to establish payer relationships and ensure complianceUsed to process insurance claims and manage patient billing

Managed Care Credentialing focuses on verifying provider credentials and establishing payer relationships, while Medical Billing Specialists handle billing processes and insurance claims. Both roles are essential in healthcare administration but serve different functions within the revenue cycle.

More about Managed Care Credentialing jobs

What states have the most Managed Care Credentialing jobs?

States with the most job openings for Managed Care Credentialing jobs include:

What other helpful pages are available for Managed Care Credentialing?

Other pages related to Managed Care Credentialing:

Infographic showing various Managed Care Credentialing job openings in the United States as of September 2026, with employment types broken down into 2% As Needed, 71% Full Time, 20% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $50,665 per year, or $24.4 per hour.

Coordinator, Managed Care, Credentialing

Remote

Navista
51 - 200 employees

Other

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


Job description

Coordinator, Managed Care, Credentialing

Managed Care contributes to Cardinal Health Practice Operations Management oversees the business and administrative operations of a medical practice. Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, enrollment, credentialing, and any other activity as it relates to payer interaction.

The Coordinator, Managed Care, Credentialing is responsible for ensuring an active credentialing/enrollment status with all contracted payors for all groups and providers. This position is also responsible for ensuring that all licensure is updated and active for all groups and providers.

Responsibilities

  • Responsible for documenting and tracking all credentialing/enrollment, re-credentialing/re-enrollment, and hospital privileging activities within the credentialing platform
  • Maintain and monitor all licenses and certifications in the credentialing platform to ensure compliance within all regions.
  • Participate in training sessions and special projects such as learning new system workflows, completing required training, and adopting updated processes within established timeframes.
  • Coordinate provider enrollment activities (including initial enrollments or re-credentialing) for all groups and providers.
  • Ensure all facility and provider licenses and certifications are accurate and in good standing at all times.
  • Complete all forms and supporting documents required to obtain hospital privileges for physicians, as necessary.
  • Ensure that all processing and reporting deadlines are consistently achieved.
  • Meet regularly with Credentialing Supervisor and other team members to provide updates on progress and status of credentialing and enrollment matters.
  • Performs any other functions as required by management.

Qualifications

  • At least three (3) years of experience of credentialing or payer enrollment experience in a managed care or provider setting, including experience using a credentialing database.
  • Specific knowledge of the payer environment and payer issues
  • Ability to work a flexible schedule (including overtime, and weekends), as necessary.
  • Excellent customer service and communication skills.
  • Ability to work independently and as part of a team.
  • Working experience with Excel spreadsheets and Microsoft Word documents.
  • College degree or commensurate working experience in healthcare.
  • Knowledge of basic medical terminology.
  • Credentialing database experience (such as IntelliCred, E-Vips, Vistar, Cactus, Symed, etc.)

What is expected of you and others at this level

  • Applies acquired job skills and company policies and procedures to complete standard tasks
  • Works on routine assignments that require basic problem resolution
  • Refers to policies and past practices for guidance
  • Receives general directions on standard work; receives detailed instruction on new assignments
  • Consult with supervisor or senior peers on complex and unusual problems

Anticipated Pay Range: $18.20 - $29.70

Bonus eligible: No

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

  • Medical, dental and vision coverage
  • Paid time off plan
  • Health savings account (HSA)
  • 401k savings plan
  • Access to wages before pay day with myFlexPay
  • Flexible spending accounts (FSAs)
  • Short- and long-term disability coverage
  • Work-Life resources
  • Paid parental leave
  • Healthy lifestyle programs

Application window anticipated to close. 09/05/26 *if interested in opportunity, please submit application as soon as possible.

The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.