Credentialing / Enrollment Lead

About This Opportunity

Our talent team is representing a confidential digital health organization in their search for a Credentialing / Enrollment Lead. This is a critical operational leadership role supporting provider network expansion across multiple payer relationships and provider types.

You'll own day-to-day execution for credentialing or enrollments operations, translating strategy into clear operating plans while managing both team members and virtual assistant capacity. This role reports directly to credentialing leadership and is essential to scaling provider networks while maintaining rigorous quality and compliance standards.

This position is fully remote within the United States, with the option to work from NYC if preferred.

Responsibilities

• Lead and develop a team of credentialing or enrollments associates, setting priorities, clarifying ownership, reviewing work quality, providing feedback, and ensuring accountability for outcomes
• Direct virtual-assistant capacity including work allocation, training, quality assurance, and performance monitoring
• Own complex credentialing programs end to end: payer enrollments, workflows for multiple provider types (Medical Doctors, Nurse Practitioners, Therapists, Registered Dietitians), ongoing monitoring, and delegated credentialing operations
• Build and maintain SOPs, operating cadences, quality controls, documentation standards, escalation paths, and audit-ready records
• Use metrics to manage capacity, throughput, timeliness, quality, provider experience, and execution risk; identify gaps early and lead improvement plans
• Investigate ambiguous payer, provider, or operational issues using data and primary sources; make sound tradeoffs across speed, compliance, experience, business impact, and cost
• Design scalable workflows and recommend tooling, automation, and ownership improvements in partnership with Product, Engineering, Payer Operations, Finance, Revenue Cycle Management, Clinical Operations, and Customer Experience teams
• Serve as the day-to-day escalation point, resolving blockers independently and escalating material risks with clear recommendations
• Communicate decisions, owners, deadlines, risks, and next steps clearly to team members, leaders, payers, providers, and cross-functional partners
• Build team capability by coaching associates into stronger owners and future leaders while ensuring reliable delivery against goals

What We're Looking For

• Approximately 5–9 years of experience in payer enrollment, credentialing, provider operations, healthcare operations, or a closely related field
• Meaningful credentialing domain depth across payer enrollment, provider onboarding, ongoing monitoring, delegated credentialing, accreditation, or related workflows
• Demonstrated people-leadership experience including setting priorities, directing work, giving feedback, managing performance, and developing team members
• Track record of owning complex operational programs with rigorous quality, compliance, documentation, and deadline requirements
• Experience using metrics to manage capacity, throughput, quality, timeliness, and execution risk
• Strong written and verbal communication skills with the ability to simplify complex operational or regulatory issues for different audiences
• Tech-savvy with experience improving processes through tooling, automation, or partnership with Product and Engineering teams
• Flexible, adaptable, and effective in fast-changing conditions
• Experience with Registered Dietitian credentialing workflows is valuable but not required

How We Work With You

Candidates apply directly through Get A Job.ai. Our recruiting team will conduct an initial screening to understand your background and match you with the right opportunity. We then submit qualified candidates to our client for their consideration.

Please do not contact the employer directly. All applications and communications should go through Get A Job.ai to ensure proper representation and coordination.

Pay

Compensation details will be discussed during the screening process based on experience and qualifications.

Equal Employment Opportunity: Get A Job.ai is committed to inclusive hiring practices and equal opportunity employment. We evaluate candidates based on qualifications and merit.