Credentialing Manager

Credentialing Manager page is loaded## Credentialing Manager locations:
Allied Home Office time type:
Full time posted on:
Posted Todayjob requisition :
JRAllied Home Office Located in:

Melville, New York 11747    (Must reside in CT, CO, DE, FL, GA, NE, NJ, NY, NC, OH, PA, SC, TN, TX, or WV)
As our Credentialing Manager, you’ll take the lead on all things credentialing—from initial enrollment to ongoing maintenance and delegated credentialing. This is a hands‑on role where you’ll manage your own workflow, drive process improvements, and serve as the go‑to expert for both internal teams and external partners.##
** In this role, you will:
*** Manage end-to-end credentialing, recredentialing, and payer enrollment for physicians and advanced practice providers
* Own all delegated credentialing functions, including initial credentialing, recredentialing, and ongoing compliance with delegated payer requirements
* Ensure compliance with NCQA, CMS, state, and payer-specific delegated credentialing standards
* Perform and oversee primary source verification (PSV) of licensure, education, training, experience, board certification, and other required credentials in accordance with NAMSS, NCQA, CMS, and payer standards
* Maintain credentialing files and documentation in accordance with delegated agreements and audit requirements
* Prepare complete credentialing and recredentialing files for review, approval, and documentation by appropriate leadership
* Prepare for, support, and respond to delegated credentialing audits and payer reviews, including corrective action plans when needed
* Track, manage and communicate credentialing timelines to support provider onboarding and avoid revenue delays
* Monitor expirables (licenses, DEA, board certification, malpractice coverage, etc.) and ensure timely renewals
* Serve as the primary point of contact with payers, hospitals, and delegated entities on credentialing and enrollment matters
* Maintain accurate provider data in credentialing systems, CAQH, and payer portals
* Develop, document, and continuously improve credentialing policies, procedures, and workflows
* Identify process inefficiencies and implement improvements to reduce turnaround times and operational risk
* Establish, track, and report credentialing performance metrics, including turnaround times, compliance indicators, and audit findings
* Provide regular status updates and reporting to leadership on credentialing progress, risks, and compliance matters
* Collaborate with revenue cycle, compliance, and operations teams to resolve credentialing-related issues impacting billing or participation status### ##
*
* What You Bring:

*** Bachelor’s degree or equivalent healthcare experience
* At least 5 years in healthcare credentialing
* NAMSS certifications (CPCS, CPMSM, CPES) preferred
* Experience managing delegated credentialing programs independently
* Strong understanding of commercial, Medicare, and Medicaid credentialing requirements
* Proficiency with credentialing software, CAQH, and MS Excel
* Excellent communication, relationship‑building, and critical‑thinking skills
* A high level of integrity and comfort interpreting regulations and guidelines
* Experience in Pediatrics, Family Medicine, or Allergy is a bonus!### ##
** Work Environment:
*** Remote* Primarily computer‑based with extended periods of desk work
** Compensation Offered:
** Salary - Salary Plan, 90,000.00 USD Annual The salary/rate provided complies with local regulations and reflects the potential base compensation for this role. Actual salary/rate may vary above or below based on the candidate’s experience, qualifications, and location.
** Perks & Benefits – Because You Deserve Them!
** We know that taking care of others starts with taking care of
** you.
** When you work at least
** 30 hours per week**, here’s what you get:
** Health Coverage That Works for You** – Medical, dental, and vision plans to keep you and your family covered.
** Smart Ways to Save** – Choose between a
** Flexible Spending Account (FSA)
** or a
** Health Savings Account (HSA)
** to plan for medical expenses.
** Invest in Your Future** – Our
** 401K plan
** comes with up to a
** 4% employer…