Senior Manager, Credentialing and Enrollment

We’re seeking an experienced Senior Manager of Credentialing and Enrollment to play a critical role in shaping the future of our clinical provider network. This role is designed for a strategic, analytical, and systems-oriented thinker who is eager to make an impact in a high-growth mental healthcare company. You’ll help scale our credentialing and enrollment operations, ensuring our network meets the demands of patient access in the highest quality way.

This is a highly cross-functional role that blends network development, strategic operations, and data-informed planning. You’ll collaborate with stakeholders across Network Operations, People, Finance, Product, and Commercial Growth teams.

What you’ll be doing:

Leverage your experience in behavioral health provider credentialing to develop, manage and monitor processes, policies and procedures that support the credentialing and re-credentialing processes of providers.

Interface with CAQH, insurance company credentialing leaders, provider services, human resources and operations to ensure a smooth credentialing process including, but not limited to:

CVO performance monitoring Managing report generation Provider communication (as needed) Committee set-up and provider credentials approval process and tracking Delegation audit coordination Primary source verification (PSV) tracking Communication with payers regarding delegated credentialing requirements

• Oversee the payer enrollment stage with health plans.
• Experience interacting with health plan counterparts and familiarization with the health plan landscape is a requirement.
• Oversee all aspects of the Credentialing Review Committee, including scheduling meetings, ensure documentation preparation, meeting notes, etc in partnership with the CVO.

Prepare Brightside to be a delegated credentialing entity through the development of policies and procedures. Prepare for and coordinate credentialing audits in compliance with managed care credentialing contracts. Coordinate with clinical operations and onboarding as it relates to credentialing, re-credentialing and provider access.

Requirements:

Depth of experience in Credentialing Leadership Start-up experience is highly valued Excellent communication skills, both written and verbal Deep and experienced knowledge of delegated credentialing Creative problem-solver, flexible thinking, and ability to meet deadlines with accuracy in work Highly organized and detail-oriented Experience leading a credentialing team and excellent people management skills

Benefits:

A competitive salary Fully paid for comprehensive health care (medical, dental, vision) Pet Insurance Life Insurance & Short / Long Term Disability 401k Plan Unlimited PTO and sick leave Parental Leave Work remotely and whatever schedule works best for you Additional memberships and perks

Final offer amounts are determined by multiple factors including geographic location as well as candidate experience and expertise. If you have questions on compensation bands, please ask your recruiter.

Brightside Health is committed to equal employment opportunities for all team members. Every decision we make regarding employment is solely based on merit, competence, and performance. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We realize the full promise of diversity and want you to bring your whole self to work every single day.

Research shows that underrepresented groups typically apply only if they meet 100% of the criteria listed. At Brightside, we are dedicated to fair play and encourage women, people of color, and LGBTQ+ job seekers to apply for positions even if they don’t check every box for the role.