Director of Credentialing (Remote)

OverviewDirector of Credentialing (Remote) at Skin And Cancer InstituteSkin And Cancer Institute is seeking a Director of Credentialing to lead and manage all aspects of provider credentialing, payer enrollments, and delegated credentialing agreements across a multi-site dermatology practice. This role ensures compliance with regulatory standards, payer requirements, and internal policies. The position supports qualified individuals with spinal cord injuries (SCI), with reasonable accommodation provided to support success.What You’ll DoCredentialing & Enrollment ManagementOversee the credentialing and re-credentialing of dermatologists, nurse practitioners, and other clinical staff; manage payer enrollment processes including Medicare, Medicaid, and commercial insurance plans; ensure timely and accurate submission of applications, verifications, and updates using CAQH, PECOS, Availity; maintain records in credentialing software systems; monitor expirations of licenses, certifications, and malpractice insurance.Delegated Credentialing OversightAdminister delegated credential agreements with payers and ensure full compliance with contractual obligations; coordinate audits, reporting, and corrective actions; serve as the primary contact for payer credentialing departments and regulatory bodies.Leadership & Team DevelopmentSupervise credentialing staff, provide guidance and training, develop and implement credentialing policies, workflows, and standard operating procedures; collaborate with HR, Compliance, and Revenue Cycle teams to align credentialing with onboarding and billing processes.Process Improvement & Strategic PlanningIdentify and implement process improvements to enhance efficiency and accuracy; lead initiatives to automate credentialing workflows and integrate systems; track and report KPIs to executive leadership.What We’re Looking ForREQUIRED SKILLS / ABILITIESIn-depth knowledge of credentialing, payer enrollment, and delegated credentialing processes.Proficiency in credentialing platforms (e.g., CAQH, PECOS, ModMed, Availity).Strong leadership, organizational, and communication skills.Ability to manage multiple priorities and meet mitment to inclusive practices and accessibility.Education & ExperienceBachelor’s degree in healthcare administration, business, or related field (master’s preferred).5+ years of experience in credentialing and enrollment, with 2+ years in a leadership role.Experience managing delegated credential agreements and audits.Familiarity with NCQA standards and CMS guidelines.What We OfferCompetitive salary and benefitsHealth, dental, vision, and ancillary insurance options401K retirement savingsPaid time offProfessional development opportunitiesSupportive and fair work environmentApply today by submitting your resume and cover letter to . We look forward to meeting you! #J-18808-Ljbffr

Created: 2025-10-04