Allied Home Office

Located in:

Melville, New York 11747

Are you a credentialing pro who loves owning your process from start to finish? Do you enjoy creating order, ensuring compliance, and working closely with providers and payers to keep things moving smoothly? If so, you might be the perfect fit for our Credentialing Manager role.

(Must reside in CT, CO, DE, FL, GA, NE, NJ, NY, NC, OH, PA, SC, TN, TX, or WV)

As our Credentialing Manager, you’ll take the lead on all things credentialing—from initial enrollment to ongoing maintenance and delegated credentialing. This is a hands‑on role where you’ll manage your own workflow, drive process improvements, and serve as the go‑to expert for both internal teams and external partners.

In this role, you will:

Manage end-to-end credentialing, recredentialing, and payer enrollment for physicians and advanced practice providers
Own all delegated credentialing functions, including initial credentialing, recredentialing, and ongoing compliance with delegated payer requirements
Ensure compliance with NCQA, CMS, state, and payer-specific delegated credentialing standards
Perform and oversee primary source verification (PSV) of licensure, education, training, experience, board certification, and other required credentials in accordance with NAMSS, NCQA, CMS, and payer standards
Maintain credentialing files and documentation in accordance with delegated agreements and audit requirements
Prepare complete credentialing and recredentialing files for review, approval, and documentation by appropriate leadership
Prepare for, support, and respond to delegated credentialing audits and payer reviews, including corrective action plans when needed
Track, manage and communicate credentialing timelines to support provider onboarding and avoid revenue delays
Monitor expirables (licenses, DEA, board certification, malpractice coverage, etc.) and ensure timely renewals
Serve as the primary point of contact with payers, hospitals, and delegated entities on credentialing and enrollment matters
Maintain accurate provider data in credentialing systems, CAQH, and payer portals
Develop, document, and continuously improve credentialing policies, procedures, and workflows
Identify process inefficiencies and implement improvements to reduce turnaround times and operational risk
Establish, track, and report credentialing performance metrics, including turnaround times, compliance indicators, and audit findings
Provide regular status updates and reporting to leadership on credentialing progress, risks, and compliance matters
Collaborate with revenue cycle, compliance, and operations teams to resolve credentialing-related issues impacting billing or participation status

What You Bring:

Bachelor’s degree or equivalent healthcare experience
At least 5 years in healthcare credentialing
NAMSS certifications (CPCS, CPMSM, CPES) preferred
Experience managing delegated credentialing programs independently
Strong understanding of commercial, Medicare, and Medicaid credentialing requirements
Proficiency with credentialing software, CAQH, and MS Excel
Excellent communication, relationship‑building, and critical‑thinking skills
A high level of integrity and comfort interpreting regulations and guidelines
Experience in Pediatrics, Family Medicine, or Allergy is a bonus!

Work Environment:

Remote
Primarily computer‑based with extended periods of desk work

Compensation Offered:

Salary - Salary Plan, 90,000.00 USD Annual

The salary/rate provided complies with local regulations and reflects the potential base compensation for this role. Actual salary/rate may vary above or below based on the candidate’s experience, qualifications, and location.

Perks & Benefits – Because You Deserve Them!

We know that taking care of others starts with taking care of you. When you work at least 30 hours per week, here’s what you get:

🩺 Health Coverage That Works for You – Medical, dental, and vision plans to keep you and your family covered.

💰 Smart Ways to Save – Choose between a Flexible Spending Account (FSA) or a Health Savings Account (HSA) to plan for medical expenses.

📈 Invest in Your Future – Our 401K plan comes with up to a 4% employer match, helping you grow your savings.

🌴 Take a Break, You’ve Earned It – Paid Time Off to relax, recharge, or handle life’s little surprises.

🛡 Peace of Mind – Life happens, and we’ve got you covered with Basic Life Insurance, Supplemental Life Insurance, and NYS Short-Term Disability (STD).

🔹 Extra Protection – Optional supplemental insurance products for added security.

💙 Wellness Matters – Access to wellness programs and coaching to keep you feeling your best.

🐾 Care for Your Fur Family – Access to pet insurance options to help with unexpected vet expenses.

🎉 Exclusive Discounts – Employee discount programs to save on things you love.

🚀 Be Part of Something Bigger – Join a growing organization that puts exceptional patient care at the heart of everything we do.

This organization participates in E-Verify. We are an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, domestic status, civil union status, pregnancy, employee’s or dependent’s reproductive decision making, veteran status, military status, sexual orientation (including actual or perceived heterosexuality, homosexuality, bisexuality and asexuality), gender identity or expression, predisposing genetic characteristic, genetic information, Acquired Immune Deficiency Syndrome or HIV status (AIDS/HIV status), arrest record, status as a victim of domestic violence, past convictions (in accordance with applicable law), or any other characteristic protected by applicable federal, state or local laws.

Credentialing Manager

In this role, you will:

What You Bring:

Work Environment:

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