Director of Payer Contracting & Credentialing | Brooklyn, NY · $100,000–$150,000 - 2646

Director of Payer Contracting & Credentialing | Brooklyn, NY · $100,000–$150,000

About the Role

A fast-growing healthcare company is expanding nationwide and opening in new states at a rapid pace. It needs a Director of Payer Contracting & Credentialing to own the contracting process in-house. This person will make sure every new state launch is licensed, credentialed and contracted, so the company can serve patients and get paid from day one. It’s a high-impact leadership role for an innovative, energetic and highly responsible professional who likes building systems and keeping a lot of moving pieces on track.

New State Expansion

• Lead licensing, Medicaid enrollment and provider registration for each new state
• Gather and submit all required documents, including insurance certificates, licenses, tax forms, policies and accreditation
• Build a repeatable launch playbook so each new state opens faster than the last

Payer Contracting

• Apply to and contract with Medicaid managed care plans and other payers
• Review contract terms, negotiate rates and take every application through to approval
• Work with legal, billing and leadership on contract decisions

Compliance & Renewals

• Keep a central tracker of every license, contract, credential and expiration date
• Manage renewals and re-credentialing ahead of deadlines so payments are never interrupted
• Bring this work in-house from the current third-party vendor and build internal processes

Relationships & Leadership

• Be the main point of contact for payer representatives and state agencies
• Resolve contracting issues that affect claims or payments
• Build and lead a small contracting team as the company grows

Qualifications

• 2+ years of experience in payer contracting, credentialing or provider enrollment in healthcare
• Experience with Medicaid and managed care plans; multi-state experience is a plus
• Highly organized and detail-oriented, with strong follow-through
• Upbeat, proactive and comfortable in a fast-moving, growing company
• Paralegal or healthcare compliance background is a plus

Interested? Send your resume to sapo@bhirednyc.com.