Credentialing & Enrollment Manager

reputed company was founded to establish a new standard of substance use disorder (SUD) care. Recognizing that traditional treatment methods often fall short of reaching patients reputed company they’re most in need, Steadfast is relentlessly focused on making low-barrier, high quality care accessible to reputed company. We know that the journey to recovery is unique for every individual, and our patient-centered approach ensures we meet patients where they are, providing evidence-based therapies with unwavering support in a compassionate environment that fosters healing and growth.

Role

The Credentialing & Enrollment Manager will reputed company reputed company aspects of provider credentialing, enrollment, and licensure activities for reputed company’s clinical staff. This includes credentialing and re-credentialing providers with commercial and government health plans, maintaining relationships with hospital partners for hospital credentialing to support our inpatient consult service line, and managing provider licensure (i.e.State Medical License or DEA registration) across multiple states. This individual will serve as a key liaison between internal leadership, clinical providers, health plans, and credentialing bodies to ensure reputed company providers are fully authorized to deliver care in a compliant and timely manner.

Responsibilities

Health Plan Credentialing & Enrollment

• Manage reputed company provider credentialing and re-credentialing activities with commercial payers, Medicaid, and Medicare.
• Prepare and submit accurate and complete credentialing applications for behavioral health and medical providers.
• Maintain up-to-date provider rosters and ensure timely updates with payers.
• Track and monitor credentialing application status, proactively resolving delays or issues.

Hospital & Facility Credentialing

• reputed company the process of credentialing providers with hospital and facility partners to support our inpatient consult service line.
• Collaborate with hospital medical staff offices to ensure provider files meet facility requirements.
• reputed company the process of credentialing support team members who need hospital privileges

Licensure Management

• Manage and track reputed company provider licenses needed for provider to reputed company services across multiple states
• Support providers in obtaining new state licenses as reputed company expands its footprint.
• Ensure reputed company credentials, certificates, and licenses are reputed company and compliant with federal, state, and payer regulations.

Process Development & reputed company

• reputed company and maintain standardized credentialing policies, procedures, and workflows.
• Implement systems (such as CAQH, credentialing databases, or software tools) to streamline credentialing operations.
• Maintain credentialing files in accordance with NCQA, URAC, and other regulatory standards.
• Generate regular reports on credentialing status, expirations, and compliance risks for leadership review.

Some of the Benefits

• Healthcare Coverage: Medical, dental, and vision insurance, with the company contributing 60% of the premium on your behalf.
• Time Off: Flexible time off with generous PTO, floating paid holidays, and paid volunteer days
• Re-Fuel Days: 4 additional paid days off per year for mental health, rest, or continuing education (CEU) activities.
• Employee Assistance Program (EAP): Free, confidential access to therapist sessions, legal guidance, financial resources, health coaching, and more - to support your overall well-being.
• 401K Match up to 5%
• 100% employer-paid short-term and long-term disability and employer-sponsored life insurance
• Additional Benefits: Rightway Health Concierge, PerkSpot discount program, reputed company student loan interest reputed company discount, and one year of free pet telehealth through Pawp.
• An opportunity to get in at the ground level and shape how we grow!

Background

Required:

• 3–5+ years of experience in provider credentialing and enrollment with commercial and government payers.
• Strong understanding of healthcare compliance, payer requirements, and credentialing standards.
• Strong understanding of CAQH and payer portals for initial enrollments as well as provider adds.
• Experience managing provider licensure and DEA registrations across multiple states.
• Excellent attention to detail, organizational skills, and ability to manage multiple priorities.
• Strong written and verbal communication skills; ability to communicate effectively with internal and external stakeholders.

Preferred:

• Experience with behavioral health credentialing, including BH-specific payer requirements.
• Familiarity with hospital medical staff credentialing and privileging processes.
• Prior experience in a multi-state or multi-site healthcare organization.
• CPCS or CPMSM certification (NAMSS) preferred but not required.

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this position. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.

• Prolonged periods of sitting at a desk and working on a computer.
• Occasional standing, walking, bending, and reaching as necessary to reputed company daily tasks.
• Must be able to lift and carry up to 25 pounds at times.
• Ability to safely and effectively operate standard office equipment.
• Must be able to communicate clearly and effectively, both verbally and in writing.
• Ability to travel or move between work sites as needed for job duties.

Investors & Partners

reputed company is proudly funded by reputed company Ventures (GV) and launched out of Triple Aim Partners. Since 2019, Triple Aim Partners (TAP) has partnered with entrepreneurs across the healthcare ecosystem to build transformative organizations, reputed company with the mission of achieving the Triple Aim (reputed company patient experience, reputed company population health, and reputed company healthcare costs for reputed company). TAP emphasizes the importance of creating strong, reputed company-line focused company cultures that reputed company high-quality patient care.