Credentialing Manager - Infusion Pharmacy

Overview

The Credentialing Manager leads and oversees enterprise‑wide credentialing and recredentialing operations for pharmacies, ambulatory infusion suites, and nurse practitioner services across multiple states. This role ensures full compliance with federal, state, accreditation, and payor‑specific credentialing requirements in a highly regulated healthcare environment, while supporting organizational growth and operational excellence.

Amerita

Monday - Friday, 8:30am-5pm - Remote

• Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts
• Supplemental Coverage – Accident, Critical Illness and Hospital Indemnity Insurance
• 401(k) Retirement Plan
• Company paid Life and AD&D Insurance, Short‑Term and Long‑Term Disability
• Employee Discounts
• Tuition Reimbursement
• Paid Time Off & Holidays

• Manages day‑to‑day credentialing workflows for providers and facilities, including onboarding, recredentialing, and change management
• Supervises, mentors, and develops credentialing specialists to ensure accuracy, timeliness, and consistency across all markets
• Serves as the subject matter expert on credentialing standards related to home infusion therapy, specialty pharmacy, and ambulatory services
• Maintains compliance with CMS, state Medicaid agencies, commercial payors, and accreditation bodies (e.g., ACHC, URAC, The Joint Commission, NABP)
• Partners with contracting, revenue cycle, compliance, legal, and clinical leadership to support new business, acquisitions, and market expansion
• Oversees credentialing for multi‑state licensure, DEA registrations, NPI enrollment, and specialty pharmacy‑specific requirements
• Monitors credentialing metrics, turnaround times, and payor performance; identifies risks and implements process improvements
• Leads audits, corrective action plans, and payor inquiries related to credentialing and enrollment
• Ensures credentialing data integrity within credentialing systems, payor portals, and internal provider databases
• Develops, maintains, and updates credentialing policies, procedures, and internal controls
• Scales credentialing operations to support acquisitions, de‑novos, and rapid geographic expansion
• Standardizes credentialing practices across regions while adapting to state‑specific regulatory nuances
• Drives automation, technology adoption, and workflow efficiencies to reduce cycle time, administrative burden, and revenue leakage
• Provides executive‑level reporting on credentialing status, risks, capacity constraints, and operational readiness
• Acts as a strategic advisor on credentialing implications for new service lines, care models, and clinical programs
• Supervisory responsibility:
  Yes

• Bachelor’s Degree in healthcare administration, business, or a related field
• Minimum of five (5) years health care experience
• Extensive experience in healthcare credentialing, enrollment, or provider operations (home infusion, specialty pharmacy, or multi‑state healthcare preferred.)
• Proven leadership experience managing credentialing teams in a complex, payor‑driven environment.
• Deep understanding of Medicare, Medicaid, and commercial payor credentialing and enrollment requirements.
• Strong analytical, organizational, and cross‑functional communication skills.
• Demonstrated ability to lead in a fast‑paced, highly regulated healthcare setting
• Percentage of Travel: 0–25%

** To perform this role will require frequently sitting, standing, walking, and typing on a keyboard with fingers, and occasionally bending, reaching and climbing (stairs/ladders). The physical requirements will be the ability to push/pull 1-10 lbs and lift/carry 21-30 lbs**

Amerita, an affiliate of Bright Spring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit  Follow us on Facebook, Linked In, and X.

USD $85,000.00 - $ / Year