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Credentialing and Payer Enrollment Manager

Remote

At Affect, we are a mission-driven organization where your work directly and immediately impacts the well-being of others. Every day, you play a critical role in our ability to deliver high-quality medical and behavioral services through our digital recovery program—helping people rebuild their lives, strengthen their families, and create lasting change in their communities.

We are expanding our Credentialing and Revenue Operations group and seeking an experienced Credentialing & Payer Enrollment Manager to lead, scale, and continuously improve our national credentialing and payer enrollment function. This individual will design resilient systems, manage day-to-day operations, guide team members and vendors, and ensure a seamless, compliant process that directly supports access to care and revenue integrity.

This is a high-impact role in a fast-paced, rapidly evolving environment. You’ll thrive here if you enjoy building systems, solving complex operational puzzles, and working cross-functionally to keep a growing clinical organization running smoothly.

Key Responsibilities:

  • Credentialing Process Design & Optimization
    • Own and continuously improve the end-to-end credentialing and enrollment lifecycle for all providers across our operations
    • Build scalable processes and documentation that support rapid company growth, new state/programmatic expansions, and evolving payer requirements
    • Implement a systems-thinking approach to credentialing, ensuring workflows integrate cleanly with RCM, compliance, recruitment, finance, and clinical operations
    • Evaluate and deploy new tools, data workflows, and automation opportunities to increase speed, accuracy, and visibility across credentialing processes
    • Monitor KPIs, cycle times, and bottlenecks; develop and execute improvement plans
  • Payer Enrollment & Credentialing Operations
    • Oversee all payer enrollment activities (Medicaid, Employer, Marketplace, and Medicare plans), ensuring timely and accurate submission, follow-through, and completion
    • Maintain continuous compliance with payer, state, and federal standards—including revalidations, expirables, and recredentialing cycles
    • Serve as the internal expert on credentialing requirements, payer nuances, and market-specific rules
    • Maintain meticulous provider records, audit-ready documentation, and updated data across credentialing platforms and internal systems
  • People Leadership & Vendor Management
    • Lead a growing credentialing and payer enrollment team, ensuring accountability, quality, and operational discipline across 20+ states and growing
    • Manage external credentialing vendors, including performance oversight, SLAs, and integration with internal workflows
    • Troubleshoot issues, set priorities, and guide the team through high-volume or fast-changing periods
  • Stakeholder Management, Reporting, and Accountability 
    • Develop strategic relationships with payer representatives to accelerate enrollment cycles and resolve issues
    • Serve as Affect’s main representative to payers regarding credentialing questions, escalations, and operational nuances
    • Deliver clear, proactive communication to internal stakeholders about provider status, risks, and projected go-live timelines
    • Produce regular executive-level reporting on credentialing timelines, enrollment progress, risk areas, and performance metrics
    • Maintain dashboards or tracking systems that give leadership real-time visibility into enrollment status and throughput
  • Cross-Functional Collaboration
    • Partner closely with RCM, Finance, and Operations to troubleshoot enrollment/credentialing barriers impacting claims or reimbursement
      Work hand-in-hand with Clinical & People Operations to ensure provider onboarding timelines remain aligned with credentialing realities

Qualifications:

  • 5+ years of experience in healthcare credentialing or payer enrollment, ideally in a multi-state environment
  • Proven success designing or managing scalable, systematized credentialing workflows
  • Experience with credentialing software and data systems; ability to learn and implement new tools; familiarity with Verifiable is a plus
  • Deep understanding of Medicaid and commercial payer credentialing requirements
  • Strong organizational ability, operational rigor, and comfort managing many moving pieces simultaneously
  • Exceptional communication and relationship-building skills—with both internal teams and stakeholders
  • Ability to thrive in a fast-paced, rapidly changing environment, maintaining accuracy and composure under pressure
  • Behavioral health familiarity is a plus, but not required

We are unable to sponsor H-1 B visas at this time.  Please do not apply if you are not in a US time zone.

 

 

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