The Credentialing & Enrollment Specialist II manages the full lifecycle of provider credentialing, including application submission, primary source verification, and payer enrollment. They also serve as a resource for team members, maintain provider data accuracy, and support compliance and revenue protection efforts.
The role focuses on growing, engaging, and retaining members by owning the customer journey and optimizing onboarding workflows. Key duties include developing lead nurture campaigns, reducing member churn, and analyzing KPIs to improve treatment success.
Lead the technical iteration of the top-of-funnel and intake experiences to drive member growth and conversion. Collaborate with cross-functional teams to build scalable platforms and leverage AI to streamline complex healthcare workflows.
Lead technical development for Enterprise systems covering eligibility, claims, billing, and payer integrations. Partner with Product and Operations teams to transform complex healthcare regulations into reliable, maintainable software.
