Director of Payer Credentialing and Contracting for 360 Care
Description
Director of Payer Credentialing and Contracting
Location: Louisville, KY
Location: Louisville, KY
Dean Dorton, a top and full-service business advisory firm, is assisting our client – 360care – in the recruitment efforts for a Director of Payer Credentialing and Contracting.
As a critical operational function within 360care, this position plays a pivotal role in ensuring the seamless onboarding of providers, effective payer enrollment, and optimal contractual relationships with insurance carriers and third-party payers. The ideal candidate will bring a strong background in healthcare credentialing, payer contracting, and operational leadership, combined with a demonstrated ability to align administrative processes with broader organizational objectives.
Who is 360care:
Based in Louisville, KY, 360care is a leading provider of on-site vision, dental, podiatry, audiology, behavioral health, and primary care services for residents of senior care and long-term care communities. You can learn more about 360care and the work they’re doing within our healthcare community at https://360care.com/.
What You’ll Be Doing:
- Oversee the full provider onboarding and facility credentialing lifecycle to ensure readiness for patient care.
- Lead end-to-end credentialing and re-credentialing processes, maintaining compliance with all regulatory entities.
- Manage all payer enrollment activities and proactively resolve issues to prevent delays or gaps in participation.
- Negotiate and manage payer contracts, including reimbursement terms, performance clauses, and renewal timelines.
- Conduct financial analyses to evaluate contract terms and assess impact on organizational revenue and sustainability.
- Collaborate cross-functionally with HR, clinical leadership, finance, and operations to align credentialing efforts with strategic goals.
- Lead and develop a high-performing team, fostering a culture of accountability, efficiency, and continuous improvement.
- Maintain robust systems for credentialing data, contract tracking, and operational reporting.
- Stay informed on evolving payer trends, industry best practices, and regulatory developments affecting credentialing and enrollment.
Who We Are Looking For:
- A Bachelor’s degree in Healthcare Administration, Business, or a related field is required. A Master’s degree is strongly preferred.
- Minimum of 7–10 years of progressive leadership experience in provider credentialing, payer enrollment, and contract management.
- Demonstrated success managing credentialing across multiple sites or specialties, including hospitals and ambulatory care settings.
- Extensive experience negotiating and managing payer contracts.
- Deep understanding of regulatory frameworks (e.g., NCQA, CMS, CAQH, etc.).
- Proficient in credentialing and contract management software (e.g., VerityStream, Symplr, Modio).
- Strong leadership, communication, and analytical skills.
- Exceptional attention to detail and a proven ability to manage competing priorities under tight timelines.
This is an exciting opportunity to influence the operational backbone at 360care. The Director of Payer Credentialing and Contracting will have direct visibility with senior leadership and play a key role in supporting organizational scalability, compliance, and financial performance. If you are looking for your next challenge in your career, we would love to hear from you!
Dean Dorton and 360care are Equal Opportunity Employers. We are committed to growing and empowering an inclusive community which is why we hire and cultivate diverse teams of the best and brightest from all backgrounds, experiences, and perspectives across our organization. We encourage you to apply for our available positions, even if you don't necessarily check every box on the description.