Manager - Provider Enrollment & Credentialing

About the Role:

The Manager – Provider Enrollment & Credentialing will be responsible for overseeing the end-to-end provider enrollment, credentialing, and re-credentialing processes for healthcare providers across multiple payers.

This role involves managing a team, ensuring compliance with payer and regulatory requirements, maintaining strong client relationships, and driving process efficiency and quality across all credentialing operations.

Location

Key Responsibilities:

Team & Operations Management

• Lead and mentor the Credentialing and Provider Enrollment team, ensuring productivity, accuracy, and adherence to SLAs.
• Oversee day-to-day operations related to CAQH management, payer applications, NPI, and Medicare/Medicaid enrollments.
• Manage re-credentialing, demographic updates, and enrollment follow-ups with payers.
• Ensure completion of applications, verifications, and documentation within defined timelines.

Process Improvement & Compliance

• Establish and maintain process documentation, SOPs, and performance trackers.
• Monitor quality and turnaround time (TAT) and implement corrective actions when required.
• Ensure all credentialing processes comply with NCQA, CMS, and payer-specific regulations.
• Identify process gaps and recommend automation or standardization opportunities.

Client & Stakeholder Communication

• Serve as a primary point of contact for clients, addressing escalations and ensuring satisfaction.
• Collaborate with cross-functional departments (Operations, IT, HR, Quality) to support smooth functioning of credentialing workflows.
• Conduct regular business review meetings (internal & client-facing) to present performance and improvement metrics.

Reporting & Metrics

• Track and report KPIs including application submission, approval rates, and error percentages.
• Generate weekly/monthly performance reports and share insights for leadership review.

Qualifications:

• Bachelor’s degree in Healthcare, Business Administration, or related field (Master’s preferred).
• Minimum 8 years of RCM experience with at least 3 years in credentialing management.
• Prior experience in client handling and process transition will be an added advantage.

Why Join Knack RCM:

• Work with one of the most trusted and established names in the RCM industry.
• Opportunity to lead a growing credentialing vertical with strong client exposure.
• Transparent, performance-driven environment with structured growth path.
• Employee-friendly culture that values skill, ownership, and innovation.