Credentialing Manager

Department: Credentialing

Location: Remote (U.S.) - Must reside in GA, AL, TX, FL, TN

Position Summary

The Credentialing Manager (Remote) is responsible for leading and managing all aspects of provider credentialing and contracting for ZÖe Center for ABA and Development Services, LLC. This role ensures that all providers meet payer, regulatory, and accreditation requirements, while maintaining efficient, accurate, and compliant credentialing processes in a fully remote work environment.

The Credentialing Manager will serve as the primary point of contact between payers, providers, and internal departments, supporting timely enrollments, renewals, and reimbursement readiness through strong organization, communication, and technical skills, and will supervise the Credentialing Specialist.

Education and Experience

• Minimum 2 year of experience in medical staff services, managed care credentialing, or a related healthcare field (required)
• Associate's degree or higher in a related field (preferred)
• Professional licensing experience (required)
• Proficiency with CMS, CAQH, NPI, and payer/credentialing systems/platforms (required)

Key Responsibilities

• Oversee all aspects of provider credentialing and re-credentialing for all clinicians across both organizations.
• Manage payer enrollment processes, ensuring timely applications, renewals, and updates for all providers.
• Coordinate contracting activities with both commercial and government payers, linking providers to the appropriate payer networks.
• Review and interpret payer contracts in collaboration with leadership and finance to ensure alignment with company standards and reimbursement goals.
• Maintain current knowledge of payer requirements, credentialing regulations, and industry standards.
• Develop, maintain, and update credentialing policies, procedures, and provider manuals.
• Use credentialing software and digital tools to track application progress, manage expirables, and ensure data accuracy.
• Communicate proactively with payers, providers, and internal departments via virtual meetings, email, and project management tools.
• Partner with billing and compliance teams to ensure accurate setup of provider information for claims processing and payment.
• Ensure compliance with all federal, state, and accreditation standards and with HIPAA data privacy regulations.
• Generate and distribute regular credentialing status reports and performance metrics to leadership.

Job Skills and Qualifications

• Strong understanding of healthcare credentialing and payer enrollment processes.
• Highly organized, self-motivated, and able to work independently in a remote setting.
• Excellent time management skills with the ability to handle multiple priorities and meet deadlines.
• Strong written and verbal communication skills, including virtual collaboration with remote teams.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and virtual platforms such as Zoom, and Google Suite.
• Experience using credentialing management software and online payer portals.
• Analytical and problem-solving skills, with a proactive approach to issue resolution.
• Demonstrated ability to maintain confidentiality and adhere to HIPAA and organizational standards.
• Positive attitude and commitment to the organization's mission and values.

Work Environment

• This is a remote position; a reliable internet connection and dedicated workspace are required.
• Regular virtual meetings with internal and external stakeholders.
• Occasional travel may be required for meetings, training, or conferences.
• Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Job Type: Full-time

Pay: From $50,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Vision insurance

People with a criminal record are encouraged to apply

Application Question(s):

• Are you located in GA, AL, TN, TX, or FL?

Experience:

• credentialing: 1 year (Required)

Work Location: Hybrid remote in Jacksonville, FL 32223