Credentialing Manager/Director at Integrated Dermatology

Boca Raton, Florida, United States -

Full Time

Start Date

Immediate

Expiry Date

06 Mar, 26

Salary

0.0

Posted On

06 Dec, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing, Provider Enrollment, Leadership, Compliance, Team Development, Payer Relationships, Performance Management, Problem Solving, Communication, Organizational Skills, Continuous Improvement, Healthcare Administration, Regulatory Requirements, Data Management, Microsoft Office, Credentialing Management Systems

Industry

Medical Practices

Description

Company Description Integrated Dermatology (ID) is a leading national dermatology organization dedicated to partnering with top-tier dermatology practices across the United States. Our unique model empowers dermatologists by preserving their clinical autonomy while providing comprehensive operational support. At ID, our success is rooted in a culture that values collaboration, accountability, and excellence. Our team is composed of driven professionals who work hard to ensure the long-term success of our partner practices. We are seeking an experienced and strategic credentialing and provider enrollment leader to drive and optimize operations across a rapidly growing national network. This individual will oversee a team responsible for ensuring all providers are accurately credentialed and enrolled with government and commercial payers in a timely, compliant, and efficient manner. The ideal candidate will have a strong background in non-delegated credentialing, deep knowledge of payer requirements, proven leadership experience, and a proactive mindset focused on continuous improvement. This role may be hired at the Manager or Director level, depending on qualifications. Job Description Develop, implement, and enforce policies and procedures for credentialing and payer enrollment across all states and markets. Oversee the full lifecycle of credentialing and recredentialing for providers, ensuring accuracy, compliance, and timeliness. Lead, mentor, and manage credentialing and enrollment staff, including performance management, training, and team development. Ensure accurate, up-to-date provider data in internal systems and payer portals Monitor and maintain compliance with CMS, NCQA, URAC, federal/state regulations, and payer-specific requirements. Collaborate cross-functionally with finance, contracting, revenue cycle, legal, operations, and clinical leadership to support timely provider onboarding and billing readiness. Serve as the primary point of contact for escalated issues with payers, regulatory agencies, and partner practices. Maintain strong relationships with payer representatives and credentialing contacts. Provide regular status updates and reports to executive leadership, including key performance indicators (KPIs), risk areas, and opportunities for process improvement. Qualifications Bachelor’s degree required in healthcare administration, business, or related field; Master’s degree preferred. Minimum 5 years of experience in non-delegated healthcare credentialing and payer enrollment, with at least 2 years in a leadership capacity. Deep understanding of credentialing standards, payer enrollment protocols, and federal/state regulatory requirements. Hands-on experience with PECOS, CAQH, NPPES, Availity, and other credentialing/enrollment platforms. Demonstrated ability to lead, coach, and develop high-performing teams in a fast-paced environment. Excellent communication, organizational, and problem-solving skills. Technically proficient with Microsoft Office and credentialing management systems (e.g., Verity, Medallion, Modio, or similar). Proven ability to manage confidential and sensitive information with discretion. Additional Information Job Type: Full-time #LI-REMOTE Education: Bachelors Degree (Required) Masters Degree (Preferred) All your information will be kept confidential according to EEO guidelines. Integrated Dermatology and it's entities provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Responsibilities

The Credentialing Manager/Director will develop and enforce policies for credentialing and payer enrollment while overseeing the full lifecycle of credentialing for providers. They will also lead and mentor a team, ensuring compliance with regulations and maintaining relationships with payers.