Associate Director Credentialing

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

 

We are seeking a dynamic and experienced Associate Director of Credentialing to lead and oversee credentialing and health plan enrollment operations across the Mid-Atlantic and Midwest regions. This role is responsible for ensuring compliance with regulatory standards, optimizing credentialing and enrollment workflows, and managing regional teams to support provider onboarding, maintenance, and payer enrollment. The ideal candidate is a strategic leader with a deep understanding of credentialing, health plan processes, and multi-site operations.

 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

 

Primary Responsibilities:

• Leadership & Oversight:
  • Lead credentialing and enrollment teams across the Mid-Atlantic and Midwest regions, ensuring consistent performance and adherence to organizational standards
  • Serve as the primary point of contact for regional leadership, providers, and external partners regarding credentialing and enrollment matters
• Credentialing & Compliance:
  • Ensure credentialing processes comply with NCQA, CMS, and state-specific regulations
  • Oversee audits, internal reviews, and corrective action plans to maintain accreditation and regulatory compliance
• Health Plan Enrollment:
  • Oversee provider enrollment with health plans, including delegated and non-delegated processes
  • Manage provider rosters and ensure timely, accurate updates to health plans
  • Lead delegation oversight activities, including reporting, audits, and compliance with delegation agreements
  • Supervise the completion and submission of enrollment applications for non-delegated health plans
• Process Improvement:
  • Identify and implement process enhancements to improve efficiency, accuracy, and provider satisfaction
  • Leverage technology and data analytics to streamline credentialing and enrollment workflows and reporting
• Team Development:
  • Recruit, train, and mentor credentialing and enrollment staff; foster a culture of accountability, collaboration, and continuous improvement
  • Conduct regular performance evaluations and provide coaching to support professional growth
• Cross-Functional Collaboration:
  • Partner with Provider Relations, Compliance, IT, and other departments to support integrated provider onboarding and lifecycle management
  • Represent credentialing and enrollment in cross-regional initiatives and strategic planning efforts

 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 7+ years of experience in healthcare credentialing and/or provider enrollment, with 3+ years in a leadership role
• Solid knowledge of NCQA, CMS, and state-specific credentialing and enrollment requirements
• Proven experience managing multi-regional or multi-site teams
• Proficiency in credentialing and enrollment software, including MD-Staff, CAQH, and PECOS, as well as Microsoft Office Suite

 

Preferred Qualifications:

• CPCS or CPMSM certification from NAMSS
• Experience in a large healthcare system, MSO, or payer organization
• Excellent communication, organizational, and problem-solving skills

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.