Manager of Credentialing - Remote

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 diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Manager of Credentialing serves as the subject matter expert for all credentialing functions, including onboarding, initial credentialing, and recredentialing, while directly managing 10 employees. This role requires deep expertise in NCQA standards, as well as federal and state regulations, and is responsible for leading and facilitating the Credentialing Committee, including presenting and reviewing provider files for discussion and decision-making.

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

Primary Responsibilities

• Lead and manage the end-to-end credentialing and recredentialing process for clinicians of Home and Community Care in accordance with State, Federal, NCQA standards, and contracted health plan requirements.
• Support and ensure successful completion of pre-delegation and annual audits for all credentialing delegated entities.
• Collaborate with onboarding, provider data, provider enrollment, network operations, credentialing committee, legal, compliance, and market operations to align credentialing data with organizational and regulatory standards.
• Analyze and interpret credentialing data and reporting to support operational performance and strategic initiatives.
• Establish, implement, and monitor departmental goals, compliance metrics, turnaround times, and quality standards for credentialing workflows.
• Conduct regular audits to validate provider data accuracy and ensure credentialing information is current and compliant with licensure and certification requirements.
• Leverage deep knowledge of credentialing database schema, data tables, and field definitions to build, analyze, and maintain high-quality reports.
• Supervise daily credentialing operations, including task assignment, staff oversight, performance evaluation, and workflow optimization.
• Foster a culture of accountability, adaptability, and high performance by leading through example and supporting team development.
• Apply strong problem-solving skills to identify root causes, propose actionable solutions, and implement continuous improvements in credentialing operations.
• Subject matter expert with CAQH, MD-Staff, and Microsoft Suite (Outlook, Excel and PowerPoint)

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:

• 5+ years of experience with credentialing/re-credentialing and/or privileging in the healthcare industry
• 3+ years of experience with health care accreditation and regulatory standards including NCQA requirements
• 3+ years of supervisory experience
• Proficiency with MS Excel & Word
• Demonstrated ability to develop correspondence to facilities and clinicians

Preferred Qualifications:

• MD-Staff experience
• Ad hoc query reporting experience

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

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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.