Director of Credentialing and Payer Relationship ManagementEye Health America, LLC • Easley, SC, US
Director of Credentialing and Payer Relationship Management
Eye Health America, LLC • Easley, SC, US
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job_description.job_card.job_descriptionLead negotiation, renegotiation, and implementation of payer contracts in collaboration with revenue cycle and legal teams. Build and maintain strong relationships with commercial and government payer representatives to enhance contract performance and resolve escalations. Analyze payer mix, reimbursement trends, and performance metrics to support strategic decisions. Serve as a liaison between payers and internal stakeholders including billing, clinical, and operations teams. Partner with executive leadership to identify new payer opportunities and support growth into new markets. Provide regular reporting on credentialing status and contract performance, including rate improvement opportunities and provider onboarding risks. Ensure integration of newly acquired practices into credentialing and payer systems seamlessly. Competitive compensation and performance incentives Comprehensive benefits including medical, dental, vision, and 401(k) Career growth opportunities within a fast-growing healthcare platform A collaborative and mission-driven culture focused on delivering exceptional patient care Bachelor’s degree required; Master’s degree in healthcare administration, business, or related field preferred. Minimum 7 years of experience in healthcare credentialing and payer contracting, with 3+ years in a leadership role. Experience working in a multi-specialty or surgical group practice, ideally within eye care or a similar high-volume specialty. Proficient in credentialing software (Modio, OneApp, CAQH) and Medicare / Medicaid portals. Demonstrated success in payer contract negotiations and rate analysis. Strong organizational, interpersonal, and communication skills. Ability to lead and mentor a high-performing credentialing and contracting team.
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 :
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Director Credentialing • Easley, SC, US
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