Credentialing Manager | ABA

Behavior Frontiers

$80K — $85K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Healthcare Administration, Business Administration, or related field preferred; equivalent experience may be accepted.
  • 3-5 years of healthcare credentialing, provider enrollment, or contracting experience required.
  • Previous supervisory or management experience preferred.
  • Experience with multi-state credentialing is strongly preferred.
  • Familiarity with commercial insurance plans, Medicaid, Medicare, and Tricare preferred.
  • Proficient with CAQH, NPPES, PECOS, payer portals, and credentialing databases.
  • Strong organizational, analytical, and problem-solving skills.

Responsibilities

  • Supervise and manage daily operations of the Credentialing Department.
  • Monitor application statuses and resolve delays or barriers.
  • Oversee credentialing, recredentialing, enrollment, and provider maintenance activities for compliance.
  • Manage departmental databases and conduct regular audits of provider files.
  • Build relationships with payer representatives and regulatory agencies for effective collaboration.
  • Participate in strategic planning and support contract development for market expansion.
  • Prepare reports on department metrics and lead continuous process improvement initiatives.

Benefits

  • Competitive pay with optional On-Demand paychecks through DailyPay.
  • 401K Plan with company match after 6 months of employment.
  • Paid Personal Time Off and Holidays.
  • Medical, Dental, and Vision Insurance provided.
  • Free 24/7 Telehealth access for you and your dependents with no co-pays.
  • Employee Assistance Program for financial, legal, and counseling support.
  • Discounted gym memberships and access to fitness resources.
  • Exclusive discounts with over 500 companies and travel essentials.
  • Significant discounts on routine lab work and prescription medications.
Full Job Description
Salary Range: $80,000 - $85,000

Responsibilities

Team Leadership & Daily Operations

As the leader of our Credentialing Department, you will supervise and manage daily operations, focusing on workflow distribution, prioritization, and employee development. You will actively monitor application statuses, processing timelines, and department work queues to quickly identify and resolve delays or barriers. In this capacity, you will serve as the primary escalation point for complex credentialing, enrollment, contracting, and payer-related issues. You will also drive team success through continuous training, performance management, and quality assurance initiatives.

Credentialing, Compliance & Data Integrity

You will oversee all credentialing, recredentialing, enrollment, and provider maintenance activities to ensure strict compliance with payer, regulatory, and organizational requirements. A core part of this role involves ensuring that provider licenses, certifications, NPI records, and CAQH profiles remain perfectly current. To maintain operational visibility and data integrity, you will manage departmental databases and tracking tools while conducting regular audits of provider files. You will also be responsible for developing and maintaining the department's standard operating procedures (SOPs) and policies, all while upholding strict confidentiality regarding protected health information, employees, and company operations.

Stakeholder Collaboration & Strategic Growth

Collaboration is essential in this role. You will build and maintain effective relationships with payer representatives and regulatory agencies, while partnering internally with Operations, Recruiting, HR, and Clinical Leadership to support seamless provider onboarding and location roster maintenance. As the organization grows, you will participate in strategic planning related to market expansion by supporting contract development initiatives, researching new funding sources, and staying highly informed on federal, state, and accreditation requirements. By tracking key department metrics, you will prepare reports for leadership and lead continuous process improvement initiatives to increase the department's overall efficiency and scalability. You will also take on special projects and additional duties as assigned.

Requirements

Qualifications
• Education: Bachelor's degree in Healthcare Administration, Business Administration, Healthcare Management, or a related field preferred; equivalent experience may be considered.
• Experience: 3-5 years of healthcare credentialing, provider enrollment, contracting, or related experience required.
• Leadership: Previous supervisory, lead, or management experience preferred.
• Multi-State Expertise: Multi-state credentialing and provider enrollment experience strongly preferred.
• Payer Knowledge: Experience working with commercial insurance plans, Medicaid, Medicare, Tricare, and other funding sources preferred.
• Systems Proficiency: Experience with CAQH, NPPES, PECOS, payer portals, and credentialing databases.
• Core Competencies: Strong organizational, analytical, problem-solving, and project management skills.
• Time Management: Ability to manage multiple priorities, meet deadlines, and collaborate effectively across departments.

Benefits

Why Behavior Frontiers is perfect for you:
• Competitive pay with optional On-Demand paychecks through DailyPay - get paid on your own schedule!
• 401K Plan with company match after 6 months of employment
• Paid Personal Time Off
• Paid Holidays
• Medical, Dental and Vision Insurance
• Performance and promotion raises
• Free Telehealth: Free 24/7 access to a doctor via telehealth for you and your dependents with no limits and no co-pays
• Free Telehealth Mental Health: Free access to a mental health counselor via telehealth for you and your dependents (over age 13) with no limits or co-pays
• Employee Assistance Program: Free access to some support services (financial, legal, counseling etc.)
• Fitness: Discounted monthly gym membership to 12,000 gym locations nationwide, as well as free access to workout videos
• Deals: Exclusive discounts and savings to 500+ companies and more!
• Travel: Discounts of travel essentials including hotels, rental cars, flights, excursions and more!
• Lab Testing Discounts: 10-80% off costs of routine lab work
• New Benefits RX: Discounts on prescription medications from 10-80% at 60,000+ locations nationwide

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