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Credentialing & Enrollment Manager

Key Facts

Remote From: 
Full time
Senior (5-10 years)
48 - 48K yearly
English

Other Skills

  • Non-Verbal Communication
  • Time Management
  • Teamwork
  • Organizational Skills
  • Detail Oriented
  • Problem Solving

Roles & Responsibilities

  • 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; proficient with CAQH and payer portals for initial enrollments and provider adds
  • Experience managing provider licensure and DEA registrations across multiple states
  • Excellent attention to detail, organizational skills, and ability to manage multiple priorities with strong written and verbal communication

Requirements:

  • Manage all provider credentialing and re-credentialing activities with commercial payers, Medicaid, and Medicare; maintain rosters and monitor status
  • Oversee hospital/facility credentialing for inpatient service line; collaborate with hospital staff to meet facility requirements; supervise credentialing support team for hospital privileges
  • Manage licensure and DEA registrations across multiple states; support providers in obtaining new state licenses as the company expands; ensure licenses are current and compliant
  • Develop and implement standardized credentialing policies, procedures, and workflows; implement systems to streamline credentialing operations and generate regular compliance reports

Job description

Steadfast Health was founded to establish a new standard of substance use disorder (SUD) care. Recognizing that traditional treatment methods often fall short of reaching patients when they’re most in need, Steadfast is relentlessly focused on making low-barrier, high quality care accessible to all. 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 oversee all aspects of provider credentialing, enrollment, and licensure activities for Steadfast Health’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 all providers are fully authorized to deliver care in a compliant and timely manner.  

Responsibilities  

Health Plan Credentialing & Enrollment 

  • Manage all 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 

  • Oversee 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. 
  • Oversee the process of credentialing support team members who need hospital privileges 

Licensure Management 

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

Process Development & Oversight 

  • Develop 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, SoFi student loan interest rate 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 perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

  • Prolonged periods of sitting at a desk and working on a computer. 
  • Occasional standing, walking, bending, and reaching as necessary to perform 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   

Steadfast Health is proudly funded by Google 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, all with the mission of achieving the Triple Aim (better patient experience, better population health, and lower healthcare costs for all). TAP emphasizes the importance of creating strong, front-line focused company cultures that enable high-quality patient care.    

 

 

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