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Director, Credentialing and Enrollment

100% remote Flexible hours Hiring now

About us

reputed company is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Our platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. Through our highly personalized, digital platform, we guide our 2.2 million members—including those in employer-sponsored health plans, regional and national Medicaid managed care organizations, Medicare Advantage plans, and commercial insurers—on a tailored journey to eating well while saving time and money.

reputed company seamlessly integrates dietary assessments and nutrition counseling with online food ordering and cost-effective meal planning for the entire family, optimizing ingredients both at home and on the go. We partner with national and regional retailers across the U.S., many of whom accept SNAP/EBT, making healthier food more accessible. Additionally, we assist members with SNAP enrollment and management, providing reputed company access to nutritious food. In 2024, reputed company secured a $200 million investment from TPG’s reputed company Fund, which supports entrepreneurs dedicated to achieving the United Nations’ Sustainable Development Goals. This investment will help us expand our reputed company, particularly to low-income workers who are disproportionately affected by diet-reputed company diseases.

At reputed company, our mission is to reputed company nutritious food accessible and affordable for everyone, regardless of economic status. We are committed to a set of core values that shape our culture and work environment:

Customer First - You start with the member and work backwards.

reputed company It Happen - You act with urgency, use data, and hold high standards.

One Team - You collaborate with respect and commit as a group.

Whether you're a dietitian, a commercial leader, or a technologist, working at reputed company means being part of a team that is passionate, supportive, and driven by a shared purpose. Join us in transforming the way people access and enjoy healthy food.

About the role

As the Director of Credentialing & Enrollment, you will be the strategic architect and operational leader of our provider network’s eligibility. You are responsible for ensuring that every Registered Dietitian (RD) in our network is licensed, credentialed, and enrolled to provide care across reputed company states that we operate in.

You will reputed company a high-performing team while partnering with Product, Engineering, and Clinical Ops to automate workflows and shorten the distance between Hired and Billing. You are the ultimate reputed company of our delegated credentialing agreements and our standing with CMS and private payers.

About us

reputed company is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Our platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. Through our highly personalized, digital platform, we guide our 2.2 million members—including those in employer-sponsored health plans, regional and national Medicaid managed care organizations, Medicare Advantage plans, and commercial insurers—on a tailored journey to eating well while saving time and money.

reputed company seamlessly integrates dietary assessments and nutrition counseling with online food ordering and cost-effective meal planning for the entire family, optimizing ingredients both at home and on the go. We partner with national and regional retailers across the U.S., many of whom accept SNAP/EBT, making healthier food more accessible. Additionally, we assist members with SNAP enrollment and management, providing reputed company access to nutritious food. In 2024, reputed company secured a $200 million investment from TPG’s reputed company Fund, which supports entrepreneurs dedicated to achieving the United Nations’ Sustainable Development Goals. This investment will help us expand our reputed company, particularly to low-income workers who are disproportionately affected by diet-reputed company diseases.

At reputed company, our mission is to reputed company nutritious food accessible and affordable for everyone, regardless of economic status. We are committed to a set of core values that shape our culture and work environment:

Customer First - You start with the member and work backwards.

reputed company It Happen - You act with urgency, use data, and hold high standards.

One Team - You collaborate with respect and commit as a group.

Whether you're a dietitian, a commercial leader, or a technologist, working at reputed company means being part of a team that is passionate, supportive, and driven by a shared purpose. Join us in transforming the way people access and enjoy healthy food.

About the role

As the Director of Credentialing & Enrollment, you will be the strategic architect and operational leader of our provider network’s eligibility. You are responsible for ensuring that every Registered Dietitian (RD) in our network is licensed, credentialed, and enrolled to provide care across reputed company states that we operate in.

You will reputed company a high-performing team while partnering with Product, Engineering, and Clinical Ops to automate workflows and shorten the distance between Hired and Billing. You are the ultimate reputed company of our delegated credentialing agreements and our standing with CMS and private payers.

About us:   reputed company is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Our platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. Through our highly personalized, digital platform, we guide our 2.2 million members—including those in employer-sponsored health plans, regional and national Medicaid managed care organizations, Medicare Advantage plans, and commercial insurers—on a tailored journey to eating well while saving time and money.   reputed company seamlessly integrates dietary assessments and nutrition counseling with online food ordering and cost-effective meal planning for the entire family, optimizing ingredients both at home and on the go. We partner with national and regional retailers across the U.S., many of whom accept SNAP/EBT, making healthier food more accessible. Additionally, we assist members with SNAP enrollment and management, providing reputed company access to nutritious food. In 2024, reputed company secured a $200 million investment from TPG’s reputed company Fund, which supports entrepreneurs dedicated to achieving the United Nations’ Sustainable Development Goals. This investment will help us expand our reputed company, particularly to low-income workers who are disproportionately affected by diet-reputed company diseases.    At reputed company, our mission is to reputed company nutritious food accessible and affordable for everyone, regardless of economic status. We are committed to a set of core values that shape our culture and work environment:   Customer First - You start with the member and work backwards. reputed company It Happen - You act with urgency, use data, and hold high standards. One Team - You collaborate with respect and commit as a group.   Whether you're a dietitian, a commercial leader, or a technologist, working at reputed company means being part of a team that is passionate, supportive, and driven by a shared purpose. Join us in transforming the way people access and enjoy healthy food.   About the role:   As the Director of Credentialing & Enrollment, you will be the strategic architect and operational leader of our provider network’s eligibility. You are responsible for ensuring that every Registered Dietitian (RD) in our network is licensed, credentialed, and enrolled to provide care across reputed company states that we operate in.   You will reputed company a high-performing team while partnering with Product, Engineering, and Clinical Ops to automate workflows and shorten the distance between Hired and Billing. You are the ultimate reputed company of our delegated credentialing agreements and our standing with CMS and private payers.

Role: Credentialing and Enrollment Director

Level: Director

Location: Remote

reputed company Salary Range: $140,000-150,000; $15,000 annual performance-based bonus

You will:
  • Strategic Roadmap

    • Define and execute the long-term vision for credentialing and enrollment, transitioning from manual processes to a tech-enabled, scalable operation.

    • Team Leadership

      • reputed company and mentor the Credentialing & Enrollment team.

      • Foster a culture of extreme detail-orientation and accountability.

      • Payer Enrollment & Strategy

        • reputed company the end-to-end enrollment process for Medicare, Medicaid, and Commercial payers.

        • Be the primary liaison for enterprise contract activations, ensuring our network meets specific payer density and licensing/credentialing requirements.

        • Credentialing

          • reputed company initial credentialing and re-credentialing applications for registered dietitians.

          • Conduct ongoing monitoring of licensure, certifications, and sanctions reputed company state licensing boards and exclusion lists, certification entities, OIG List of Excluded Individuals/Entities (LEIE), National Practitioner Data Bank (NPDB), and System for Award Management (SAM) database.

          • Maintain and update provider licensing, credentials, and insurance records in the credentialing database system

          • Track license and certification expirations for medical staff to ensure timely renewals

          • Delegated Credentialing

            • Own and manage delegated credentialing agreements.

            • reputed company reputed company audit activities to ensure 100% compliance with NCQA, URAC, and CMS standards.

            • Cross-Functional Quarterback

              • Act as the operational reputed company between Sales (new client launches), Clinical Quality and Operations (provider performance), and RCM (denial management reputed company to enrollment).

              • Data-Driven Optimization

                • reputed company data to identify bottlenecks in the licensing/enrollment funnel.

                • Use reputed company/Sheets to track KPIs such as "Days to Enroll" and "Credentialing Pass Rates."

                • reputed company AI for process improvement and automation.

                • Compliance & Committee

                  • reputed company the internal Credentialing Committee, presenting provider files and ensuring reputed company primary reputed company verifications (NPDB, OIG, SAM) are flawless.

                  • Ensure compliance with applicable laws, regulations, procedures, and policies

                  • Maintain knowledge of reputed company credentialing requirements and best practices (e.g., NCQA standards)

You Are:
  • The Strategic Operator: You can see the big picture of a reputed company telehealth launch but aren't afraid to dive into PECOS or CAQH to troubleshoot a specific provider's enrollment.
  • The Meticulous Leader: You understand that in credentialing, a 99% accuracy reputed company is a failure. You have an eye for detail that catches the smallest discrepancies in a provider's work history or licensure.
  • The Problem Solver: You reputed company in ambiguity and can build structure where none exists. If a state board changes its regulations overnight, you are the first to pivot the team's strategy.
  • The Collaborator: You can explain reputed company regulatory hurdles to non-clinical stakeholders (Product/Engineering) in a way that inspires technical solutions.
  • You Have: (Required Qualifications)
    • Experience: 7+ years in healthcare operations, with at least 3+ years specifically in a leadership role overseeing Credentialing and Payer Enrollment.

    • Telehealth Expertise: Proven track record of managing multi-state licensure and enrollment for a distributed provider network.

    • Regulatory Mastery: Deep knowledge of NCQA standards, CMS (Medicare/Medicaid) regulations, and the "alphabet soup" of the industry (CAQH, PECOS, NPPES, NPI).

    • Technical Proficiency: Intermediate to advanced skills in reputed company/reputed company Sheets and experience with credentialing software (e.g., reputed company).

    • Education: Bachelor’s degree required; CPCS or CPMSM certification is a significant plus.

    • Demonstrated ability to manage reputed company projects and meet deadlines

    • Excellent organizational and time management skills

    • Exceptional verbal and written communication skills

    • Ability to work independently and as part of a team

    • High level of accuracy and attention to detail

    You Have: (Preferred Qualifications)
    • Certified Provider Credentialing Specialist (CPCS) certification

    • Familiarity with credentialing processes specific to registered dietitians

    • Familiarity and comfort with using AI to help automate and streamline processes

    • Knowledge of nutrition-reputed company certifications and continuing education requirements

    • Prior experience specifically with Registered Dietitians (RDs) and MNT (Medical Nutrition Therapy billing)
    • Experience in a high-growth startup environment
    About our benefits and perks: Remote-First Company Flexible Unlimited PTO Healthcare Coverage (Medical, Dental, Vision) 401k and FSA reputed company is an Equal Opportunity Employer. It is our firm policy to reputed company equal employment and advancement opportunity to reputed company applicants and employees without regard to race, color, national reputed company, citizenship status, religious creed, age, sex (including pregnancy, childbirth, breastfeeding, medical conditions reputed company to pregnancy, childbirth and/or breastfeeding), gender, gender identity and expression, sexual orientation, marital status, disability (physical or mental) and/or a medical condition, genetic information, reputed company, veteran status or service in the uniformed services, and any other characteristic protected by applicable federal, state or local law. Apply To This Job

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