Key Responsibilities:

• Lead day-to-day credentialing operations for behavioral health professionals, including therapists, psychiatrists, psychologists, and counselors.
• Manage the credentialing and re-credentialing processes in accordance with NCQA, CMS, and state-specific regulations.
• Review provider applications, verify qualifications, and ensure completion of credentialing files.
• Liaise with payers and health plans to facilitate provider enrollment and maintain active status.
• Supervise and train credentialing staff, ensuring team performance goals are met.
• Maintain accurate and up-to-date provider databases and credentialing systems.
• Track license expirations, malpractice insurance, and other required documentation.
• Collaborate with internal departments (HR, Compliance, Provider Relations) for onboarding and audit readiness.
• Generate reports and present credentialing metrics and status updates to management.
• Respond to internal and external inquiries regarding credentialing status and policies.

Requirements:

• Bachelor’s degree.
• Strong knowledge of NCQA, CMS, and state-specific credentialing standards.
• Excellent organizational, analytical, and communication skills.
• Proficiency with credentialing software and provider databases.
• Ability to lead a team and manage multiple priorities in a fast-paced environment.

Experience:

• 2–3 years of experience in credentialing within a behavioral health setting.
• Previous experience leading or supervising a credentialing team is preferred.