Credentialing Manager

Compensation: $45-50/hour W2

Schedule: Monday–Friday, 40 hours/week

Location: Oak Brook, IL | Initially onsite with hybrid flexibility after training

Start: Targeting September 2026

Our Client, a well known medical practice, is looking to expand the team and focused on an experienced Credentialing Manager to join a large, established healthcare organization supporting a complex physician network. This is a hands‑on leadership opportunity for someone who brings deep experience across provider credentialing, payer enrollment, Medicare/Medicaid, revenue cycle operations, and high‑volume physician‑group environments. The Credentialing Manager will lead a team of credentialing professionals while maintaining direct oversight of critical enrollment, recredentialing, payer roster, and compliance activities.

• Lead day‑to‑day provider and facility credentialing, recredentialing, and payer enrollment operations.
• Manage and develop a credentialing team consisting of 5+ professionals, including a supervisor.
• Oversee commercial payer enrollment as well as Medicare and Medicaid enrollment and revalidation processes.
• Manage credentialing calendars, expiration dates, renewal requirements, compliance deadlines, and provider data.
• Coordinate and oversee payer roster submissions to maintain accurate provider participation and reduce credentialing‑related claim issues.
• Lead EFT/ERA enrollment activities across commercial and governmental payers.
• Administer payer, credentialing, and provider portals, including access and provider information.
• Work closely with Revenue Cycle Management to resolve enrollment issues that may affect billing, reimbursement, or claim processing.
• Coordinate credentialing activities involving Physician‑Hospital Organizations (PHOs) and other affiliated organizations.
• Partner with Revenue Cycle, Compliance, Legal, Operations, providers, and external payer organizations.
• Develop reporting and tracking mechanisms around credentialing status, deadlines, performance metrics, and compliance risks.
• Identify opportunities to improve credentialing workflows, technology reporting, and overall operational efficiency.
• Establish clear standards for accuracy, accountability, service, and team performance.

• 5–7+ years of medical credentialing and/or payer enrollment experience, including progressively responsible experience.
• Demonstrated experience leading, supervising, or mentoring credentialing professionals.
• Strong hands‑on knowledge of:
• Provider credentialing and recredentialing
• Medicare and Medicaid enrollment/revalidations
• Payer roster management
• Provider and payer portal administration
• Experience working closely with Revenue Cycle Management operations.
• Background supporting a large physician group, medical group, health system, MSO, or similarly complex healthcare organization.
• Strong proficiency with CAQH, PECOS, payer portals, and credentialing technology/platforms.
• Ability to manage large volumes of provider information while maintaining excellent accuracy and compliance.
• Strong project management and organizational skills with the ability to manage multiple deadlines simultaneously.
• Excellent communication skills and the ability to work effectively with physicians, payers, operational leadership, and senior executives.
• Bachelor's degree in Healthcare Administration, Business Administration, or a related discipline preferred.

• Experience supporting or working with Physician‑Hospital Organizations (PHOs).
• CPCS or CPMSM certification.
• Multi‑state credentialing experience.
• Experience supporting large or high‑volume provider populations.
  
  Familiarity with value‑based care arrangements.
• Experience improving credentialing workflows, reporting, tracking systems, or technology.