Credentialing & Contracting Manager

NIVA Health

. Own the credentialing process from accepted offer through provider readiness and ongoing maintenance.

Posted 10/2/2026full-timeRemote • Sri LankaMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider credentialing operations, including managing payer enrollment, provider contracting, and lifecycle maintenance. Proficient in developing KPIs and reporting for performance visibility while ensuring compliance with Medicare, Medicaid, and commercial payer requirements.

Highest-signal resume keywords

Provider CredentialingPayer EnrollmentProvider ContractingProject ManagementMicrosoft Excel

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider CredentialingPayer EnrollmentProvider ContractingProject ManagementKPI DevelopmentReportingProcess ImprovementCredentialing SoftwareDatabase ManagementAudit-Ready Documentation

Soft Skills

Organizational SkillsCommunication Skills

Industry Keywords

MedicareMedicaidCommercial PayerHealthcare OperationsCollaborative Practice Agreements

About the role

Key responsibilities & impact

Own the credentialing process from accepted offer through provider readiness and ongoing maintenance.
Manage and hold the third-party credentialing vendor accountable for timelines, quality, service levels, and results.
Establish credentialing priorities based on provider start dates, patient access, business growth, geographic expansion, and payer requirements.
Lead status reviews, identify barriers and delays, and escalate risks affecting provider start dates or patient care.
Oversee provider contracting, including employment, independent contractor, collaborative practice, supervising physician, medical director, telehealth, delegation, and related agreements.
Ensure provider contracts are executed before patient care begins and maintain renewal and expiration schedules.
Oversee Medicare, Medicaid, and commercial payer enrollment and maintain accurate enrollment reporting.
Partner with Revenue Cycle and Billing to resolve enrollment-related claims and reimbursement issues.
Own provider lifecycle maintenance, including licenses, certifications, DEA registrations, malpractice coverage, collaborative agreements, practice locations, supervising physicians, and state expansions.
Lead credentialing and contracting activities for provider offboarding, including payer notifications, contract terminations, and system updates.
Maintain complete, current, audit-ready provider files.
Develop KPIs, dashboards, SOPs, and reporting for leadership visibility into credentialing performance.
Identify opportunities for automation, process improvement, and standardization.
Serve as NIVA Health’s subject matter expert on provider credentialing operations.
Partner with HR, Clinical Operations, Revenue Cycle, Billing, Finance, Compliance, Legal, and Executive Leadership.

Requirements

What you’ll need

5+ years of progressive experience in provider credentialing, payer enrollment, provider contracting, or healthcare operations.
Strong working knowledge of Medicare, Medicaid, and commercial payer enrollment.
Experience with provider credentialing and contracting, including collaborative practice agreements.
Experience managing multiple provider onboarding and credentialing projects simultaneously.
Experience managing or holding a third-party credentialing vendor accountable.
Strong organizational and project management skills.
Advanced Microsoft Excel and reporting skills.
Experience working with provider databases and credentialing software.
Excellent written and verbal communication skills.
Bachelor's degree in Healthcare Administration, Business Administration, Human Resources, or a related field is preferred.