About Carepatron
At Carepatron, we're building the practice management platform that lets health and wellness practitioners spend more time with clients and less time on admin. Tens of thousands of practitioners across mental health, allied health, physical therapy, and specialty care already run their practices on Carepatron, and we're on a mission to make great healthcare experiences universal — for practitioners and the people they serve.
We're a distributed team across New Zealand, Australia, the US, the UK, and beyond. Small enough that your work is visible and your judgement is trusted; serious enough that the systems you help build support hundreds of thousands of real care experiences every week.
About the Role
As our Credentialing and Provider Enrollment Lead, you'll own the end-to-end credentialing and enrollment lifecycle for the providers our customers work with. That means getting new providers enrolled with payers quickly and cleanly, keeping existing enrollments in good standing through re-credentialing cycles, and making sure nothing falls through the cracks — because in credentialing, a missed deadline is a month of unbillable revenue.
You'll also build and lead the playbook for how Carepatron does this as we scale: choosing systems, defining SLAs, hiring alongside you, and making sure the function stays fast, clean, and audit-ready as provider volume grows.
What You'll Do
- Run the full enrollment lifecycle: new enrollments, re-credentialing, revalidations, demographic updates, and closeouts — across commercial, Medicare, Medicaid, and Medicare Advantage plans.
- Own CAQH ProView, PECOS, and NPPES profiles for our providers, plus state-specific Medicaid enrollments wherever we operate.
- Manage payer applications end-to-end: submission, follow-up, and approval — holding payers accountable to their own SLAs and escalating when they slip.
- Build and maintain the credentialing calendar so re-credentialing, license, DEA, malpractice, and board certification renewals are never a surprise.
- Partner with providers to collect documentation quickly and painlessly — CVs, licenses, W-9s, malpractice, disclosures — and escalate anything holding up an application.
- Coordinate across Contracting, Legal, Billing, and RCM on participation strategy, network gaps, and fee schedule reviews.
- Unstick the hard stuff: enrollment denials, retro-enrollment, par/non-par status changes, group vs individual enrollments, and hospital/facility-specific requirements.
- Design the function: choose the tooling, define SOPs and SLAs, and build the processes that keep credentialing clean and on time at scale.
- Hire, mentor, and grow a team over time as our provider volume increases — you'll be the first senior hire in this area.
What You'll Bring
- 6+ years of credentialing and provider enrollment experience across commercial and government payers in the US.
- Demonstrated ownership of at least a few hundred concurrent enrollments and re-credentialing cycles.
- Deep, current knowledge of CAQH ProView, PECOS, NPPES, and major commercial and state Medicaid systems.
- A strong process mindset — you build trackers, playbooks, and escalation paths instead of relying on memory and luck.
- Experience managing or mentoring credentialing specialists, even informally.
- Clear, confident communication with providers, payer representatives, internal stakeholders, and executives.
- Patience and tenacity: you've gotten a stuck enrollment moving by knowing exactly who to call and what to cite.
- High comfort working remotely and asynchronously across time zones.
Nice to Have
- Certified Provider Credentialing Specialist (CPCS) or CPMSM certification.
- Experience setting up or migrating credentialing software (e.g., Modio, Medallion, Verifiable, symplr).
- Background in behavioral health, PT/OT/SLP, or specialty care credentialing.
- Experience building a credentialing function from scratch at a fast-growing company.
- Familiarity with hospital/facility privileging alongside payer enrollment.
Why Join Us
If you care about healthcare done well, want to work with people who take craft and customers seriously, and prefer getting things done over performing busy-ness, you'll fit here. We back people to own their area, review each other's work honestly, and keep a calm rhythm — no performance-review theatre, no surprise weekend fire drills.
What We Offer
- Fully remote work with flexible hours that respect your time zone
- A mission-led team that ships, reviews, and backs you to own your area
- Clear paths to grow as Carepatron's RCM function scales
- Meaningful equity in a profitable, fast-growing healthcare company
- A calm, focused culture — outcomes over optics
How to Apply
Send us your CV and a short note about a credentialing or enrollment challenge you've owned end-to-end — what was stuck, what you did, and what it unlocked.
We read every application. No cover letter template required — just make it real.
