Responsibilities

As Payer Enrollment Manager, you will oversee and audit the performance of Credentialing Verification Organizations (CVOs), lead audits and ongoing monitoring for delegated contracts, manage all payer credentialing and enrollment functions across delegated and non-delegated arrangements, ensure compliance with NCQA, CMS, state, and commercial payer credentialing requirements, develop and optimize workflows for application submission, recredentialing, and ongoing monitoring, serve as the primary point of contact for payer credentialing escalations and audits, collaborate with Compliance, Product, and Revenue Cycle Management teams, track and analyze performance metrics, support the development of internal policies, and maintain detailed records and audit trails.