Director of Credentialing and Payer Relationship Management

Job Description

Job Description

Description : Eye Health America is a a rapidly growing, multi-state eye care platform with over 150 providers, 60 clinic locations, and 15 ambulatory surgery centers (ASCs). Our mission is to deliver the highest quality personalized eye care to patients across the Southeast through a collaborative network of ophthalmologists, optometrists, and surgical specialists. As we continue to expand, we are seeking a strategic and experienced Director of Credentialing and Payer Relationship Management to lead critical infrastructure supporting our provider operations and payer engagement.

The Director of Credentialing and Payer Relationship Management is a key leadership role responsible for overseeing and streamlining all aspects of provider credentialing and payer contracting. This role ensures the timely and accurate enrollment and re-credentialing of our clinical providers across all facilities, as well as leading contract negotiations and relationship management with commercial, Medicare Advantage, and Medicaid payers.

The ideal candidate brings a strong background in healthcare credentialing systems, payer contracting, and multi-site operations, and thrives in a fast-paced, growth-oriented environment.

Key Responsibilities :

Credentialing & Enrollment Management

• Oversee the end-to-end provider credentialing and re-credentialing process for 160+ providers across multiple states.
• Manage and optimize use of credentialing software platforms (e.g., Modio, CAQH, PECOS) to ensure compliance, accuracy, and efficiency.
• Ensure compliance with state and federal regulations as well as payer-specific requirements.
• Lead a credentialing team responsible for data integrity, provider file maintenance, and payer enrollment submissions.
• Develop and maintain a comprehensive dashboard to track credentialing timelines and performance KPIs.

Payer Contracting & Relationship Management

Strategic Leadership & Collaboration

What We Offer :

Requirements :