Vice President, Provider Enrollment & Credentialing

Job Title: Vice President, Provider Enrollment & CredentialingLocation: US, Remote Department: Central Business Office (CBO) Reports To: CBO LeaderFLSA Classification: Exempt, Full-timeSalary Range: $175K–$210KPosition SummaryThe Vice President, Provider Enrollment & Credentialing is the single accountable executive for the end-to-end performance of Coronis Health’s provider enrollment and credentialing services, whether delivered by our internal teams or by third-party vendor partners. This role is responsible for setting the strategy, operating model, standards, and performance expectations for the service line; ensuring providers are enrolled, credentialed, and re-validated accurately and on time so clients can bill and get paid; and governing a blended delivery model so that internal and vendor work is held to the same standards and measured through the same metrics. The Vice President partners with Onboarding, Account Management, Billing and A/R, Compliance, Technology, Finance, and other stakeholders to deliver consistent client outcomes, healthy margins, and a scalable, well-governed service. Key Responsibilities§ Strategic Vision, Service Ownership & Drive for Resultso In partnership with the CBO Leader, set the vision, strategy, and multi-year roadmap for provider enrollment and credentialing, including which services, payers, and specialties are delivered in-house versus through vendor partners, and where.o Serve as the single point of accountability for client outcomes across the service line, regardless of delivery model (internal US, India, or Philippines teams, or vendor).o Partner with Sales, Onboarding, and Account Management to scope, price, and launch enrollment and credentialing services for new and existing clients, including specialty-specific requirements (e.g., anesthesia and other hospital-based specialties).§ Operational Excellence & Data-Driven Decision Makingo Establish and publish a standard set of operating metrics and reporting for the entire service line, including application submission turnaround, time to effective date, payer approval cycle time, clean-application rate, pending-application aging and backlog by payer, on-time re-credentialing and revalidation, and rework, so that performance is visible, comparable, and actionable.o Design, implement, and maintain standardized workflows, documentation, and quality assurance protocols that apply consistently across internal teams and vendors, while remaining compliant with all applicable regulations, payer requirements, accreditation standards, and policies.o Oversee effective use of enrollment and credentialing systems and payer and registry portals (e.g., CAQH, PECOS, NPPES, and payer-specific portals), and drive technology and automation improvements that increase throughput, accuracy, and visibility.o Manage payer relationships and escalation pathways to resolve delays, backlogs, and application issues quickly and to improve payer-specific cycle times.o Drive continuous process improvement, root-cause analysis of rework and denials attributable to enrollment or credentialing errors, and implementation of best practices.§ Vendor & Delivery Model Governanceo Own the vendor strategy for provider enrollment and credentialing, including vendor evaluation and selection, input into contracting and statements of work, onboarding, and transition planning.o Define and enforce service level agreements, KPIs, quality standards, and reporting requirements for vendor partners; run a regular governance cadence (e.g., weekly operational reviews and quarterly business reviews) and lead performance remediation, escalation, and, where needed, exit.o Maintain a unified, side-by-side view of internal and vendor performance, and use it to inform decisions on workload allocation, insourcing, outsourcing, and transitions to India or the Philippines.o Manage vendor spend, volumes, invoicing accuracy, and commercial terms against budget and expected outcomes.o Partner with Compliance and Information Security to ensure vendors meet data privacy, security, and audit requirements for protected health information and provider data.§ Client Outcomes & Retentiono Improve client retention through better enrollment and credentialing outcomes, measured through metrics such as service delivery within turnaround time and contractual SLAs, time to first billable claim for newly enrolled providers, enrollment-related denials, and escalation volume.o Serve as an executive escalation point and, where needed, executive sponsor for key client relationships, with clear and proactive client communication on status and risks.§ Change Leadership, Executive Influence & Collaborationo Lead and develop the internal provider enrollment and credentialing organization across the US, India, and the Philippines, including organization design, role clarity, and capacity planning.o Work directly and collaboratively with colleagues in both India and the Philippines, ensuring clear communication, shared standards, consistent quality, and effective coverage across time zones.o Develop a high-performing team through, but not limited to, intentional talent development, succession planning, a multi-skilled workforce, and best-in-class employee engagement and retention.o Foster collaboration and partnership across Onboarding, Account Management, Billing and A/R, Compliance, Technology, Finance, and vendor partners, cultivating a unified One Team culture that crosses functional, business unit, geographic, and company boundaries.Key Success Measures§ Financial: Budget v/s actual spend, gross margin, vendor cost per enrollment or credentialing action, $ cost savings.§ Operational: Application turnaround and time to effective date, clean-application rate, backlog and pending-application aging, on-time re-credentialing and revalidation, quality scores, % reduction in rework.§ Client: Client complaints & escalations, client retention %, time to first billable claim, enrollment-related denials, NPS score.§ Vendor: SLA attainment, vendor quality scores, vendor issue resolution time, spend v/s contract.§ People: Staffing ratio, engagement score, top talent development.Qualifications & Experience§ Bachelor’s degree in Healthcare Administration, Business, or an equivalent field (Master’s preferred); credentialing or revenue cycle certification (e.g., CPCS, CPMSM, CRCR) preferred.§ 12+ years of progressive experience in provider enrollment, credentialing, payer operations, or revenue cycle management, including 5+ years in a senior leadership role and experience at a vendor providing this service or from a physician group that conducts this function in-house.§ Demonstrated experience leading a blended delivery model, including managing vendor and outsourced services through SLAs, KPIs, and formal governance, as well as internal teams, including teams located in India and the Philippines.§ Working knowledge of payer enrollment and delegated or payer credentialing processes, registry and payer portals (e.g., CAQH, PECOS, NPPES), and applicable accreditation and regulatory standards (e.g., NCQA, CMS).§ Exceptional people leader with the ability to inspire confidence, trust, and followership with a track record of developing teams and talent.§ Strong business & financial acumen, client management, and excellent communication skills with an innate ability to articulate complex ideas in a simple manner.§ A data-oriented operator with strong analytical & problem-solving skills; and demonstrable experience of building operating metrics and reporting that drive action.§ Hands-on experience driving productivity and quality improvements through process changes, standardization, & automation. Competencies§ Strategic Vision & Drive for Results§ Operational Excellence & Data-Driven Decision Making§ Vendor & Partner Management§ Customer-Centricity & Change Leadership§ Executive Influence & Collaboration Additional information: This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve. Coronis Health is committed to creating a diverse and inclusive environment where all employees are treated fairly and with respect. We are an equal-opportunity employer, providing equal opportunities to all applicants and employees regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other protected characteristic. We welcome and encourage applications from candidates of all bac