Note: The job is a remote job and is open to candidates in USA. Theoria Medical is a comprehensive medical group and technology company serving patients across the care continuum, with an emphasis on post-acute and primary care. The Payer Credentialing Manager leads payer credentialing and re-credentialing for healthcare providers, oversees payer enrollments and credentialing staff, maintains accurate records, and ensures compliance with accreditation and regulatory requirements.
Responsibilities
• Oversee the processing of initial payer applications for health professionals, ensuring compliance with national accreditation standards and state/federal regulations
• Maintain and manage payer credentialing databases and electronic records, ensuring accuracy, confidentiality, and audit readiness
• Liaison with medical staff leadership, payers, licensure boards, and regulatory agencies to resolve credentialing issues promptly
• Supervise payer credentialing staff by coordinating workloads, providing training, monitoring performance, and ensuring quality outcomes
• Conduct regular audits of payer credentialing processes to identify gaps, implement corrective actions, and drive continuous improvement
Skills
• Bachelor's degree in healthcare administration, business, or related field
• Minimum of 3 years in payer credentialing or healthcare administration
• 1–3 years in a supervisory or managerial role
• Demonstrated experience with payer enrollment processes
• Hands-on experience with payer credentialing systems (e.g., CAQH, Medallion)
• Strong knowledge of databases and Microsoft Office applications (Excel, Access, Word)
• Strong organizational skills, attention to detail, communication, problem –solving, and knowledge of regulatory guidelines
• Remote position, TBA
Benefits
• 401(k) with employer match
• Health, dental, and vision insurance
• PTO + paid holidays
• Life insurance coverage
• Remote flexibility with a national legal scope
Company Overview
• Theoria Medical provides post-acute care facilities, hospital systems, and emergency medical services. It was founded in 2017, and is headquartered in Novi, Michigan, USA, with a workforce of 1001-5000 employees. Its website is https://www.theoriamedical.com.