Job Overview
Location
Remote - United States
Job Type
Full-time
Category
HR & Recruiting
Date Posted
March 25, 2026
Full Job Description
đź“‹ Description
- • The Provider Credentialing & Enrollment Manager at PM Pediatrics Management Group, LLC plays a critical role in ensuring that all healthcare providers are properly credentialed and enrolled with payers, directly impacting clinical coverage, reimbursement integrity, and regulatory compliance across urgent care settings. This remote position is essential to maintaining operational continuity and financial health by preventing claims denials and supporting timely provider onboarding.
- • Day-to-day responsibilities include ensuring provider staff are credentialed and enrolled with payers to guarantee sufficient clinical coverage and minimize claims reimbursement denials; developing and implementing policies and procedures for credentialing and recredentialing processes that align with industry standards and organizational needs; managing primary source verification of education, training, board certification, work history, and licensure for healthcare providers; maintaining CMS NPPES reporting to meet federal requirements; supporting the internal credentialing committee in evaluating newly hired staff; facilitating resolution of discrepancies or concerns regarding applicants’ credentials in collaboration with medical staff leadership and providers; maintaining accurate and confidential credentialing databases and files with strict attention to data security and integrity; communicating accurate enrollment and credentialing status organization-wide to support informed decision-making; assisting the accounts receivable team with credentialing-related payer denials; coordinating with legal and compliance teams on malpractice and insurance coverage matters; and serving as the lead expert on state-specific bylaws to ensure urgent care and health system applications comply with varying regional legal standards.
- • PM Pediatrics Management Group, LLC is a mission-driven organization committed to delivering high-quality pediatric urgent care with passion and customer focus. The company values employees who believe in their work and contribute to a culture of excellence, accountability, and continuous improvement in healthcare operations.
- • In this role, the individual will develop deep expertise in healthcare regulatory compliance, particularly in provider credentialing across multiple jurisdictions, and gain leadership experience in shaping policy, managing complex databases, and influencing cross-functional teams. Success in this position offers the opportunity to become a recognized subject matter expert in urgent care credentialing, directly contributing to improved provider access, reduced administrative burden, and enhanced revenue cycle performance.
🎯 Requirements
- • Minimum of five (5) years of progressively responsible operational or consulting experience in provider credentialing and enrollment in an outpatient setting
- • Proven expertise in all state bylaws governing the credentialing process for urgent care or multi-site health systems
- • Knowledge and experience of the healthcare industry or medical financial operations
- • Ability to identify patterns and conduct root cause analysis
- • Experience with CAQH (Council for Affordable Quality Healthcare) database and application process
- • Strong attention to detail and organizational skills
- • Demonstrated ability to manage multiple, concurrently running projects and adapt to changing deadlines, competing priorities, and unexpected assignments
🏖️ Benefits
- • Competitive compensation range of $95,000–$110,000 base salary
- • Fully remote work arrangement within the United States
- • Opportunity to work for a mission-driven organization committed to pediatric healthcare excellence
- • Professional growth in a specialized, high-impact area of healthcare operations with exposure to regulatory, compliance, and financial systems
- • Collaborative environment with access to medical staff leadership, compliance, legal, and accounts receivable teams
- • Stability and long-term career potential in a growing healthcare organization focused on quality and compliance
Skills & Technologies
Remote
$95k-110k
About PM Pediatrics Management Group, LLC
PM Pediatrics Management Group, LLC operates after-hours pediatric urgent care centers across the United States, providing treatment for illnesses, injuries, and common infections in children and young adults up to age 26. Clinics are open evenings, weekends, and holidays, offering on-site digital X-ray, labs, and telehealth services. The company partners with health systems and community hospitals to extend accessible pediatric care beyond traditional office hours.
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