Bpo Credentialing Director (credentialing & Enrollment Services)
Neolytix LLC
Chicago, IL, United States
On-site
Provider credentialing lifecycle management
Payer enrollment and revalidation operations
Ncqa urac cms regulatory compliance
The Director provides strategic leadership over all provider credentialing, re-credentialing, and payer enrollment functions for a diverse portfolio of healthcare clients
Job Summary
The Director provides strategic leadership over all provider credentialing, re-credentialing, and payer enrollment functions for a diverse portfolio of healthcare clients.
This role requires managing a geographically distributed global workforce across North America, Asia, and other offshore locations to ensure seamless operational continuity.
The position is responsible for leading the initiative to achieve and maintain NCQA Credentials Verification Organization certification while ensuring strict regulatory compliance.
Matching Summary
The Director provides strategic leadership over all provider credentialing, re-credentialing, and payer enrollment functions for a diverse portfolio of healthcare clients.
Skills & Requirements
Must-have
Provider credentialing lifecycle management
Payer enrollment and revalidation operations
NCQA URAC CMS regulatory compliance
Primary source verification protocols
Global team leadership and development
CAQH PECOS NPPES system proficiency
Nice-to-have
Lean Six Sigma process improvement
Delegated credentialing audit experience
Telehealth interstate licensure knowledge
Proprietary software platform collaboration
Cultural competency in global teams
Key Requirements
Bachelor's degree in Healthcare or Business Administration
5-7+ years progressive experience in credentialing and enrollment
Management experience with teams of 10+ professionals
Deep working knowledge of NCQA standards and CMS regulations
Experience in vendor or multi-client outsourcing environments