Role Description The Credentialing Operations Manager owns the engine of Metro Vein Centers’ payor enrollment output—ensuring every provider, in every state, reaches in-network status accurately, on time, and without revenue leakage. This role is built for a high-volume operator who can drive first-pass accuracy enrollments, and scale production capacity with MVC’s growth. The Operations Manager is accountable for: - Payor enrollment applications - Revalidations - Expirables management - Escalations - Provider directory updates - Attestations - Day-to-day data integrity that keeps the revenue cycle clean How You’ll Make a Difference: - Own end-to-end payor enrollment across commercial, Medicare, and Medicaid plans—initial applications, follow-ups, attestations, recredentialing, and revalidations—for all MVC clinics, physicians, and APPs. - Operate with clear ownership (state-by-state) for application throughput, payor follow-up cadence, and SLA adherence in each market. - Manage the expirables program (DEA, state licenses, board certifications, malpractice, CLIA) using CredentialStream’s alerting module; eliminate lapses before they impact billing. - Drive first-pass submission accuracy as a core KPI. Audit submissions before they leave the team and after approval is received. - Own provider change management: NPI/Tax ID updates, location adds, demographic changes, payor portal updates, and CAQH attestations across all active payors. - Serve as the operations-side partner to RCM—resolving credentialing-driven denials, enrollment gaps, and payor discrepancies, and feeding root-cause learnings back into the team. - Build and maintain the operations KPI scorecard: enrollment turnaround time, approval cycle time, first-pass accuracy, expirables compliance, and denial impact dollars. - Lead training, auditing, and QA for the operations team—including new specialists, offshore partners, and cross-training across states to eliminate single-points-of-failure. - Partner with the Credentialing Growth Manager to ensure smooth transitions from new-provider onboarding into ongoing payor maintenance and revalidation cycles. - Drive automation roadmap inside CredentialStream—payor portal automation and sunsetting of legacy spreadsheets and manual trackers. - Manage and develop operations specialists (onshore and offshore), set SLAs, KPIs, and own service-level adherence with external vendors. - Special projects as assigned. Qualifications - Bachelor’s degree or an equivalent number of years of relevant experience. - 5–8 years of direct payor enrollment and credentialing experience within a multi-site, multi-state healthcare organization, with at least 3 years in an operations-focused leadership or supervisory role. - Deep working knowledge of commercial, Medicare, and Medicaid enrollment workflows, CAQH, PECOS, NPPES, and payor portal mechanics. - Demonstrated track record managing high-volume application pipelines and driving measurable improvements in turnaround time and first-pass accuracy. - Strong analytical skills—able to build and operate KPI dashboards, identify bottlenecks, and quantify revenue impact of enrollment delays. - Hands-on proficiency with credentialing software platforms (e.g., CredentialStream, Modio, Symplr) and contract/RCM tools (e.g., Rivet, Athena). - Proven ability to manage offshore or vendor production capacity to defined SLAs and quality standards. - Excellent communication and escalation skills across RCM, Operations, Finance, and external payor representatives. Requirements - Experience inside a high-growth MSO, specialty medical group, ASC platform, or PE-backed healthcare organization adding multiple markets per year. - Prior experience standing up or scaling a credentialing team through a step-change in headcount (e.g., doubling specialists, integrating offshore production). - Familiarity with vascular/vein, cardiology, or other office-based procedural specialty enrollment nuances (ancillary vs. professional billing rules, site-of-service considerations). - Prior CredentialStream or other credentialing software implementation or optimization experience. Benefits - Medical, Dental, and Vision Insurance - 401(k) - Paid Time Off (PTO) + Paid Company Holidays - Company-Paid Life Insurance - Short-Term Disability Insurance - Employee Assistance Program (EAP) - Career Growth & Development Opportunities