Credentialing and Payor Operations Manager

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Requirements:

• 5+ years of experience in healthcare operations, credentialing, payor enrollment, or related fields.
• Prior leadership experience; ideally leading a team of 3+ people.
• Experience in a tech-enabled healthcare or digital health company (startups or high-growth environments preferred).
• Strong operational expertise with a track record of optimizing workflows, implementing scalable solutions, and improving efficiency.
• Familiarity with payor enrollment processes, provider credentialing, and compliance regulations.
• Experience managing cross-functional projects and working with internal teams to improve provider operations.
• Tech-savvy mindset, with experience leveraging technology to drive process improvements.
• Strong problem-solving skills and the ability to work in a fast-paced, dynamic environment.
• Excellent communication and organizational skills.

Responsibilities:

• Own & optimize credentialing and payor enrollment operations to ensure efficiency, compliance, and scalability.
• Lead process improvements across credentialing workflows, ensuring alignment with cross-functional teams (Provider Ops, RCM, Product, and Solutions teams).
• Manage provider onboarding & enrollment workflows, ensuring accurate, timely completion.
• Develop, document, and scale best-in-class operational processes to support provider enrollment & credentialing at scale.
• Collaborate with internal stakeholders to drive operational improvements and tech-enabled solutions to streamline credentialing and overall provider onboarding/experience.
• Serve as a key point of contact for payor enrollment-related issues, providing problem-solving expertise and resolution strategies.
• Support cross-functional initiatives related to provider onboarding and network expansion.
• Identify automation and tooling opportunities to enhance operational efficiency in credentialing & payor enrollment processes.