Credentialing Manager

About the role

The Credentialing & Provider Enrollment Manager will lead Charlie Health's credentialing function and the team of specialists responsible for health plan enrollment across Medicaid and Commercial payors. You will own our delegated credentialing program end-to-end - a complex, specialized area spanning provider onboarding, primary source verification, the internal credentialing committee, and required payor and NCQA audits - while setting long-term credentialing strategy and managing the day-to-day performance of the team. You will partner cross-functionally with Commercial Strategy, RevOps, RCM, and Compliance to expand delegated credentialing statuses, resolve problem payors, and continuously improve how the team operates, including through automation and AI-enabled tooling. This is a hands-on leadership role for someone who has run a delegated credentialing program before and is excited to both own the details and build the long-term strategy. We're a team of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. If you're inspired by our mission and energized by the opportunity to increase access to mental healthcare and impact millions of lives in a profound way, apply today.

Responsibilities

• Lead, manage, and develop a team of 5+ credentialing specialists, owning team KPIs including enrollment turnaround times and applications submitted & approved
• Own and operate the delegated credentialing program end-to-end, including provider onboarding, primary source verification, and maintaining NCQA-aligned standards
• Lead the internal credentialing committee - presenting cases, maintaining meeting minutes, and managing approvals
• Manage required payor audits and internal audits to ensure ongoing NCQA and delegated credentialing compliance
• Set and drive long-term credentialing strategy, partnering with Commercial Strategy to expand delegated credentialing statuses across payors
• Build and maintain a centralized "Credentialing Source of Truth" documenting payor-specific requirements (provisional credentialing, SLAs, backdating policies, etc.)
• Partner with RevOps to align on KPIs and incentive structure, and with RCM to troubleshoot problem payors and credentialing-related denials
• Identify and implement process improvements that increase team efficiency, including automation and AI-enabled workflows
• Oversee day-to-day payor and Medicaid enrollment across group and individual submissions, ensuring timely, accurate, and compliant applications tracked in Salesforce

Requirements

• Bachelor's degree
• 5+ years of experience in provider credentialing and/or health plan enrollment
• Direct, hands-on experience owning or operating a delegated credentialing program is required, including primary source verification, credentialing committee operations, and NCQA standards
• 2+ years of people management experience leading a credentialing or enrollment team preferred
• Experience with both Medicaid and Commercial payor enrollment
• Comfort with process improvement and a track record of leveraging automation and emerging technologies (including AI) to streamline operations
• Strong cross-functional collaboration skills across RevOps, RCM, Commercial Strategy, and Compliance
• Work authorized in the United States and native or bilingual English proficiency
• Familiarity with and willingness to use cloud-based communication software - Google Suite, Slack, Zoom, Dropbox, Salesforce

Benefits

Additional Information

Why Charlie Health? Millions of people across the country are navigating mental health conditions, substance use disorders, and eating disorders, but too often, they're met with barriers to care. From limited local options and long wait times to treatment that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported. Charlie Health exists to change that. Our mission is to connect the world to life-saving behavioral health treatment. We deliver personalized, virtual care rooted in connection-between clients and clinicians, care teams, loved ones, and the communities that support them. By focusing on people with complex needs, we're expanding access to meaningful care and driving better outcomes from the comfort of home. As a rapidly growing organization, we're reaching more communities every day and building a team that's redefining what behavioral health treatment can look like. If you're ready to use your skills to drive lasting change and help more people access the care they deserve, we'd love to meet you.

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