Jobgether
Credentialing Lead
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Credentialing Lead - United Kingdom
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Credentialing Lead based in United Kingdom.
This role offers the opportunity to build and lead a critical credentialing operation from the ground up.
You will design scalable workflows, establish quality standards, and oversee the full credentialing lifecycle for healthcare providers.
The position combines operational ownership, process improvement, compliance management, and team leadership.
You will play a key role in helping practices reduce administrative burdens, maintain payer access, and accelerate revenue opportunities.
Working closely with cross-functional teams, you will shape a service that delivers accuracy, reliability, and exceptional partner support.
This is an ideal opportunity for someone who thrives in a fast-paced environment and enjoys creating solutions from the ground up.
Accountabilities
The Credentialing Lead will be responsible for building, managing, and scaling a comprehensive credentialing service while ensuring operational excellence and compliance across all activities. Key responsibilities include:
- Designing and launching credentialing workflows, quality standards, operational processes, and service guidelines from the ground up.
- Managing the complete credentialing lifecycle, including application intake, primary source verification, CAQH management, payer enrollment, Medicare/Medicaid enrollment, recredentialing, and compliance monitoring.
- Ensuring credentialing files are completed accurately, efficiently, and in accordance with payer requirements and industry regulations.
- Monitoring provider statuses, licenses, sanctions, and exclusion lists to proactively identify risks and prevent disruptions to billing capabilities.
- Establishing performance metrics and operational standards to maintain strong turnaround times, accuracy, and service quality.
- Recruiting, training, and managing credentialing specialists as the service grows.
- Creating scalable processes that support increasing demand while maintaining a high level of quality and compliance.
- Collaborating with operations, sales, and leadership teams to integrate credentialing into the broader partner experience.
- Identifying opportunities to improve workflows, tools, and systems to increase efficiency and reliability.
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Requirements
The ideal candidate has extensive experience in healthcare credentialing operations, strong knowledge of payer requirements, and the ability to build and manage processes independently. Required qualifications include:
- 4+ years of experience in provider credentialing, payer enrollment, medical staff services, or related healthcare administration roles.
- Hands-on experience with CAQH ProView, PECOS, and payer-specific credentialing requirements, including Medicare, Medicaid, and commercial payers.
- Proven experience managing recredentialing cycles, compliance monitoring, and ongoing provider maintenance activities.
- Demonstrated ability to create, improve, and scale operational processes rather than only execute existing workflows.
- Experience leading teams or strong readiness to hire, train, and manage credentialing professionals.
- Strong attention to detail and ability to identify potential compliance issues before they impact operations.
- Ability to work independently, make decisions in ambiguous situations, and build solutions without predefined processes.
- Excellent organizational, communication, and problem-solving skills.
- Experience with PT, OT, or SLP credentialing is considered a strong advantage.
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Benefits
- Competitive salary based on experience and expertise.
- Opportunity to build and lead a new service function with significant ownership and impact.
- Professional development and career growth opportunities.
- Remote work flexibility.
- Opportunity to collaborate with a dynamic, supportive, and globally distributed team.
- Meaningful impact by helping healthcare practices operate more efficiently and support better patient access.
How Jobgether Works
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Why Apply Through Jobgether?
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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