56 Best humana Jobs in Bayonne, New Jersey (April 2026)

Credentialing Manager

30 days ago

New York

Job Description About Fay At Fay, our mission is to make nutrition a foundational pillar of preventative care, improving outcomes, accessibility, and affordability at scale. We're building AI-powered infrastructure to transform preventative healthcare. Think that's bold? We're just getting started. Today, Fay is a three-sided marketplace connecting providers, patients, and payers to revolutionize preventative care delivery. Our b2b2c business-in-a-box solution empowers dietitians to deliver high-quality, affordable nutrition care, helps patients take control of their health, and enables payers to build healthier member populations. Nutrition is our starting point, not the finish line. The platform we're building will expand into new areas of preventative health and wellness as we grow. We're proud to be one of the fastest-growing companies in healthtech, backed by category-defining investors like General Catalyst, Forerunner, 1984, and Goldman Sachs. Ready to leverage AI-driven technology to transform preventative care and make a real-world impact on health? Let's talk. About This Role As Credentialing Manager, you'll own provider enrollment and credentialing operations at Fay — building the systems, processes, and team structures that allow our dietitian network to scale without friction. You'll serve as the in-house expert across a dedicated set of payers and act as the critical bridge between Credentialing and Revenue Cycle Management. This is a player-coach role: you'll set strategy, author SOPs, and own SLAs — while also rolling up your sleeves on escalations and complex payer relationships. You'll report directly to the Head of Credentialing. If you want to build a credentialing function from the ground up at one of the fastest-growing healthtech companies in the country, this role is for you. What You'll Be Doing • Own a dedicated portfolio of 10–15 payers end-to-end. Be the internal subject matter expert on each payer's portal workflows, submission requirements, processing quirks, SLA windows, and escalation contacts. When something breaks, you're the one who knows why and how to fix it., • Manage a team of Provider Enrollment Specialists responsible for application execution. You'll assign and prioritize work, review submissions before they reach payers, and hold the team accountable to quality and throughput standards., • Audit existing credentialing workflows and implement scalable improvements — including technology enablement, process redesign, and smarter resource allocation. You'll drive toward a credentialing operation that can grow without growing headcount proportionally., • Define and own SLAs across the credentialing lifecycle. Track and report on key metrics — turnaround time, application accuracy, denial rates, and resubmission timelines — and proactively surface and resolve bottlenecks before they impact provider go-live dates or revenue., • 3+ years of hands-on provider credentialing and enrollment experience, with at least 2 years in a lead or management capacity — ideally at a health plan, MSO, delegated credentialing entity, or high-growth digital health company, • Deep working knowledge of CAQH ProView, NPDB queries, state licensing and scope-of-practice databases, and the enrollment portals of major commercial and government payers (e.g., Aetna, BCBS, Cigna, UHC, Humana, Medicare/Medicaid), • Demonstrated experience redesigning credentialing workflows — not just executing them — across a high volume of providers and multiple national payers simultaneously, • Experience owning credentialing KPIs and building payer health dashboards with SLA tracking and escalation management, • Strong understanding of the downstream impact of credentialing on claims, billing, and revenue cycle — and how to coordinate across those functions, • Experience credentialing allied health or telehealth providers — particularly dietitians, therapists, or other non-physician specialties, • Familiarity with delegated credentialing agreements and the operational implications of delegated vs. non-delegated payer relationships, • Background at a high-growth startup or digital health company, • Tech-savvy with a strong appetite for automation and systems that enhance speed, accuracy, and scalability Fay is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Humana jobs in Bayonne, New JerseyCreate job alerts

Popular jobs searches in Bayonne, New Jersey

Popular humana jobs locations