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Provider Credentialing Manager Jobs in Florida (NOW HIRING)

Chen Medical

Credentialing Manager

Miami Gardens, FL

We provide big answers to big problems in health care delivery. ChenMed is a full-risk primary care ... The Credentialing Manager is responsible for managing a team of credentialing professionals and is ...

Chen Medical

Credentialing Manager

Miami Gardens, FL · On-site

We provide big answers to big problems in health care delivery. ChenMed is a full-risk primary care ... The Credentialing Manager is responsible for managing a team of credentialing professionals and is ...

Nova Medical Services

Credentialing Specialist

Miami, FL · On-site

$22 - $25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Position Summary The Credentialing Specialist will be responsible for managing the credentialing and recredentialing process for healthcare providers while ensuring compliance with federal, state ...

CCP Cares

Credentialing Coordinator

Sunrise, FL · On-site

Re-credentials existing providers in all applicable lines of business from inception through ... Maintains inter-departmental relationships with Provider Operations and Provider Data Management ...

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Provider Credentialing Manager information

See Florida salary details

$30K

$55.3K

$91.7K

How much do provider credentialing manager jobs pay per year?

As of Aug 13, 2026, the average yearly pay for provider credentialing manager in Florida is $55,252.00, according to ZipRecruiter salary data. Most workers in this role earn between $41,000.00 and $64,100.00 per year, depending on experience, location, and employer.

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

Provider Credentialing Managers often encounter challenges such as managing large volumes of credentialing applications, ensuring compliance with ever-changing regulations, and coordinating across multiple departments. Effective use of credentialing software, staying updated on industry standards, and maintaining clear communication with providers and internal teams can help address these challenges. Building strong organizational systems and fostering collaborative relationships with medical staff and regulatory agencies are also key to streamlining processes and minimizing delays.

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

AspectProvider Credentialing ManagerProvider Enrollment Specialist
Primary FocusManaging provider credentialing processes, verifying credentials, maintaining provider filesEnrolling providers with insurance plans, submitting applications, ensuring payer compliance
CertificationsOften requires certifications in healthcare administration or credentialingTypically requires knowledge of insurance policies and enrollment procedures
Work EnvironmentHealthcare organizations, credentialing companiesInsurance companies, healthcare provider offices
Common TasksVerifying provider credentials, maintaining databases, compliance trackingSubmitting enrollment applications, following up with payers, updating provider information

The Provider Credentialing Manager focuses on verifying and maintaining provider credentials to ensure compliance, while the Provider Enrollment Specialist handles the enrollment process with insurance payers. Both roles are essential in healthcare administration but differ in their specific responsibilities and workflows.

What is a provider credentialing manager?

Provider Credentialing Managers are professionals responsible for overseeing the process of verifying the qualifications and credentials of healthcare providers within a medical facility or health plan. They ensure that all physicians, nurses, and allied health professionals meet the required standards set by regulatory bodies and accrediting organizations. Their role involves managing documentation, coordinating background checks, and maintaining compliance with industry regulations. This helps ensure patient safety and organizational integrity by allowing only qualified providers to deliver care. Credentialing managers often work closely with human resources, compliance departments, and external agencies.

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

To thrive as a Provider Credentialing Manager, you need in-depth knowledge of credentialing standards, healthcare regulations, and provider enrollment processes, usually supported by a bachelor's degree and experience in medical staff services. Familiarity with credentialing software, databases, and compliance management systems such as CAQH and NCQA accreditation is essential. Strong organizational skills, attention to detail, and effective communication help manage complex documentation and coordinate with providers and regulatory bodies. These skills ensure the timely and accurate onboarding of providers, mitigate compliance risks, and maintain organizational credibility.

What are the most commonly searched types of Provider Credentialing jobs in Florida?

The most popular types of Provider Credentialing jobs in Florida are:

What cities in Florida are hiring for Provider Credentialing Manager jobs?

Cities in Florida with the most Provider Credentialing Manager job openings:

Provider Credentialing Manager jobs near you
Infographic showing various Provider Credentialing Manager job openings in Florida as of August 2026, with employment types broken down into 94% Full Time, and 6% Part Time. Highlights an 82% In-person, and 18% Remote job distribution, with an average salary of $55,252 per year, or $26.6 per hour.

Credentialing Manager

Chen Medical

Miami Gardens, FL

Full-time

Re-posted 22 days ago

Job description

Company Description

ChenMed is transforming healthcare for seniors. We provide big answers to big problems in health care delivery.
ChenMed is a full-risk primary care market leader with an innovative philosophy, unique physician culture and end-to-end customized technology. These things allow us to provide world-class primary care and coordinated care to the most vulnerable population - moderate- to low-income seniors who have complex chronic diseases.
Through our innovative operating model, physician-led culture and empowering technology, we are able to drive key quality and cost outcomes that create value for patients, physicians and the overall health system.
Our model allows us to practice medicine the way it should be practiced. By recruiting focused physicians and reducing their doctor-to-patient ratios, we increase patients' "face time" during each monthly appointment and help foster stronger doctor-patient relationships. Our model also drives and enhances compliance with treatment plans.
As a result of our efforts, our patients realize lower hospital admissions. Their overwhelming response to our approach is reflected in our aggressive, organic growth and net promoter scores in the low to mid 90s, which is unheard of in any industry. Read more about our results and the value of the ChenMed model.
As a company, we are making a difference in the lives of seniors and the health care system overall.

Job Description

The Credentialing Manager is responsible for managing a team of credentialing professionals and is accountable for systems and processes that ensure compliance with organizational credentialing policies and procedures, and compliance with the credentialing requirements of our health plan partners, and related regulatory and accrediting agency requirements. This individual will oversee the initial and ongoing application process for all clinicians and is responsible for: maintaining the organization's credentialing databases and online systems, maintaining up-to-date credential files, and managing all health plan enrollments and reappointments, as well as, managing all initial and ongoing applications for medical staff privileges at ChenMed designated facilities.



Primary Duties and Responsibilities:


Ensure compliance with ChenMed's credentialing and recredentialing policies and procedures, and compliance with state, federal, accreditation and health plan credentialing requirements.
Collaborate with leadership on policy development and standardization of criteria / processes across the organization.
Maintain and ensure up-to-date credentialing files.
Responsible for the accuracy and integrity of credentialing files, credentialing database and reporting systems.
Monitors external credential databases, including CAQH, PECOS and other regulatory agencies, to ensure data is updated and ready for quick retrieval and use by interested parties.
Ensure credentialing files are complete before presentation to Credentialing Committee.
Provide consultation to Credentialing Committee / leadership on issues related to consideration of clinician credentials and reappointments.
Oversee compliance with health plan requirements related to delegated credentialing agreements and credentialing file audits.
Oversee processes and reviews (including ensuring resolution) all reports related to adverse actions such as sanctions, licensure actions or limitations, and credentialing-related complaints.
Interview, hire and train new staff on credentialing and recredentialing policies and procedures; also provides ongoing training as needed regarding new guidelines or updated processes / policies.
Daily monitoring of employee's workload and various credentialing work streams (e.g. onboarding, credentialing, pharmacy, medical staff privileging, Medicare/Medicaid enrollments, Credentialing Committee meetings, health plan enrollments, etc.).
Play an important role in making decisions regarding employee's performance issues such as the need for disciplinary counseling, performance documentation and/or termination.
Conducts periodic audits of credentialing files and staff work-product.
Oversees initial applications and reappointments for Medicare / Medicaid enrollment, hospitals, surgical centers and managed care entities for assigned divisions.
Develops and provides regular reports and presentations concerning the operation and progress of the credentialing functions, including activity related to approvals, denials and / or appeals.
Other responsibilities may include:

Monitor renewals of licensure and other documents subject to expiration, and ensures updates are forwarded to facilities and healthcare partners as renewals are received.
Oversee and coordinate health plan office site visits.
Work with leadership to identify and implement best practices related to credentialing.
Responds to facilities and health plan inquiries, interfaces with internal staff and external customers on day-to-day credentialing issues.
Collaborates with leadership on submitting and maintaining up-to-date health plan rosters.
Responsible for management and supervision of credentialing staff / team.
Upon request of supervisor, attends meetings with payer representatives to address outstanding issues.
Respond to internal / external request for credentialing and licensing status.
Develop reports to present to the leadership staff as requested.
Other activities as outlined in the credentialing and recredentialing policies and procedures.
Other duties as assigned and modified at manager's discretion.


Qualifications

Bachelor's degree in business administration or health care related field required.
Strong understanding and use of web-based credentialing applications. Experience with MDStaff preferred.
Working knowledge of NCQA, AAAHC, JCAHO, AOA, URAC and other applicable accreditation and regulatory standards
Database management skills including querying, reporting, and document generation.
Five to Seven (5-7) years of Credentialing experience required.
Two (2) year experience in a Lead/Management capacity required.
Certified Provider Medical Services Management (CPMSM) / Certified Provider Credentialing Specialist (CPCS) Certification preferred (Required to obtain certification within 6-12 months of hire).

Additional Information

Advanced knowledge of Microsoft Office Software (Excel, Access, and Word), database administration and scanning applications.
Strong organizational, verbal and written communication skills.
Ability to work effectively with staff, physicians and external customers.
Ability to work independently with limited supervision.
Multi-tasking and knowing how to set priorities.
Fluent in English.
EDUCATION / SPECIALIZED KNOWLEDGE REQUIREMENTS:

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