Credentialing Specialist

About GlyCare

GlyCare is a hospital-based consultative inpatient diabetes management service. Our team of Nurse Practitioners and Endocrinologists provides evidence-based glycemic management for non-ICU hospitalized patients improving outcomes reducing provider burden and standardizing care across facilities.

We partner directly with hospitalsno outpatient clinics no traditional practice modeland are rapidly expanding across multiple states.

Why Join GlyCare:

• Be part of a rapidly growing hospital-based clinical program
• Work in a model that is standardized evidence-based and outcomes-driven
• Play a key role in expanding into new hospitals and states
• High visibility role with direct impact on operational success

Position Overview:

We are seeking an experienced Credentialing Specialist to lead hospital privileging and payer enrollment for a growing multi-state provider group.

This is a high-impact role responsible not only for execution but also for building scalable processes. The ideal candidate can navigate complex hospital systems and payersand translate state-specific requirements into standardized workflows (SOPs) to support rapid expansion.

• Salary Range: $60000 $70000
• Experience: 46 years (multi-state strongly preferred)
• Executes credentialing and enrollment processes with minimal supervision
• Supports SOP development and process improvement
• Leads complex credentialing efforts across multiple states and hospitals
• Owns SOP development workflow design and scaling processes
• Acts as internal subject matter expert and escalation point

What Youll Do:

Hospital Credentialing & Privileging

• Manage end-to-end hospital credentialing and privileging for APPs and physicians
• Serve as the primary liaison with medical staff offices
• Track applications through committee cycles (Credentialing MEC Board)
• Ensure timely approvals aligned with onboarding and go-live timelines

Payer Enrollment

• Manage enrollment and re-credentialing with Medicare Medicaid and commercial payers
• Maintain provider participation across all required payers and facilities
• Oversee CAQH NPPES PECOS and state Medicaid portals

Multi-State Expansion & SOP Development (Key Focus)

• Research state-specific licensure credentialing and payer requirements
• Build and maintain standard operating procedures (SOPs)
• Create scalable repeatable workflows for new market entry
• Identify inefficiencies and improve turnaround times

Tracking & Compliance

• Proactively track all licenses certifications malpractice and expirations
• Ensure no gaps in privileges enrollment or compliance
• Maintain accurate provider records and credentialing files
• Document all activities within credentialing systems

What Were Looking For:

• 4 years of credentialing experience (hospital payer enrollment required)
• Experience with hospital-based groups (not outpatient-only credentialing)
• Strong knowledge of:
• Medical staff processes & privileging
• Medicare Medicaid and commercial payer enrollment
• CAQH NPPES PECOS and Medicaid portals
• Proven ability to research requirements and build SOPs/workflows
• Experience supporting multi-state credentialing (preferred)
• Ability to manage high volume and tight timelines (90120 day cycles)
• Strong organizational problem-solving and communication skills
• High attention to detail and ability to work independently

Work Environment:

• This position is onsite Monday - Friday
• Fast-paced deadline-driven environment
• Frequent coordination with hospitals payers and internal stakeholders