Director of Credentialing

# Already Autism is hiring a Director of Credentialing & Payer Contracting **Location:** Remote **Department:** Revenue Cycle Management **Reports To:** Senior Vice President, Revenue Cycle Management ## About Already Autism Health Already Autism Health is a rapidly growing, multi-state provider of Applied Behavior Analysis (ABA) therapy and autism diagnostic services committed to improving the lives of children and families. As we continue to expand into new markets, we remain focused on delivering exceptional clinical outcomes, increasing access to care, and building a best-in-class experience for our patients, providers, and team members. We are seeking a strategic, results-driven **Director of Credentialing & Payer Contracting** to lead our credentialing, provider enrollment, and payer contracting functions. This is a unique opportunity to build scalable systems, strengthen payer partnerships, and directly influence the organization's operational success and long-term growth. ## Position Summary The Director of Credentialing & Payer Contracting is responsible for developing and leading the organization's credentialing, payer enrollment, and managed care contracting strategy across multiple states. This executive-level leader will ensure providers and facilities are credentialed efficiently, optimize payer participation and reimbursement, maintain regulatory compliance, and develop scalable operational processes that support continued expansion. Working closely with Executive Leadership, Revenue Cycle Management, Clinical Operations, Finance, and Talent Acquisition, this position plays a critical role in accelerating provider onboarding, improving patient access, maximizing revenue opportunities, and supporting new clinic openings and market expansion. ## Essential Duties & Responsibilities ### Credentialing & Provider Enrollment Lead the organization's provider, group, and facility credentialing operations while developing standardized, scalable processes that support a rapidly growing healthcare organization. **Responsibilities include:** - Lead all provider, group, and facility credentialing and enrollment activities across multiple states. - Oversee credentialing and recredentialing for BCBAs, BCaBAs, Licensed Psychologists, Diagnosticians, and other credentialed providers. - Ensure timely enrollment with commercial insurance plans, Medicaid, Medicare (where applicable), and governmental programs. - Manage CAQH profiles, NPI records, PECOS registrations, state licensure tracking, and payer enrollment requirements. - Develop standardized credentialing workflows that improve efficiency and reduce provider onboarding timelines. - Establish key performance indicators (KPIs) and monitor credentialing performance to minimize delays affecting patient access and revenue. - Partner with Clinical Operations and Talent Acquisition to ensure providers are credentialed and ready to serve patients as quickly as possible. - Maintain audit-ready documentation and support accreditation reviews and regulatory inspections. ### Payer Contracting & Network Strategy Develop and execute contracting strategies that strengthen payer relationships, expand network participation, improve reimbursement, and support organizational growth. **Responsibilities include:** - Lead negotiations with commercial health plans, Medicaid Managed Care Organizations, and other payer partners. - Develop contracting strategies that support expansion into new markets and improve financial performance. - Evaluate reimbursement methodologies, fee schedules, contract amendments, and policy changes. - Perform financial and reimbursement analyses to support strategic contracting decisions. - Maintain contract inventory, renewal schedules, and contract management systems. - Collaborate with Revenue Cycle teams to resolve denials, underpayments, authorization challenges, and payer operational issues. - Monitor payer performance and identify opportunities to improve reimbu…