Location: Monsey, NY
Job Type: Full-time
Salary: $125,000 – $150,000 per year
We are seeking an experienced Compliance Director to lead credentialing, payer contracting, and compliance initiatives for a growing behavioral health and substance use disorder organization.
This leadership role is responsible for overseeing provider credentialing, commercial payer contracting, regulatory compliance, and payer relations while building scalable processes to support continued organizational growth.
Lead provider credentialing and recredentialing for physicians, clinicians, and facilities.
Manage CAQH profiles, enrollment, and credentialing timelines to prevent lapses.
Negotiate and maintain commercial payer contracts, fee schedules, and contract renewals.
Develop strong relationships with commercial insurance carriers and payer representatives.
Oversee credentialing, contracting, and authorization workflows as the organization expands.
Provide guidance regarding HIPAA, regulatory compliance, audits, and accreditation readiness.
Monitor changes in payer policies and behavioral health regulations.
Build, mentor, and lead a growing team responsible for credentialing, contracting, and payer operations.
Collaborate with executive leadership to ensure operational and regulatory compliance across multiple facilities.
Minimum 5 years of progressive healthcare credentialing, contracting, and payer relations experience.
Experience working on both the payer side (network management, provider relations, contracting, or credentialing) and provider side (healthcare organization credentialing and contracting).
Behavioral health and/or substance use disorder experience required.
Proven experience negotiating commercial payer contracts and managing credentialing cycles.
Working knowledge of commercial payers including Optum Behavioral Health, Magellan, Evernorth, Carelon, and similar organizations.
Experience with CAQH, NCQA standards, provider enrollment, and credentialing platforms.
Strong knowledge of HIPAA, HITECH, 42 CFR Part 2, MHPAEA, and applicable healthcare regulations.
Bachelor's degree in Healthcare Administration, Business Administration, or a related field.
CHC, CPCO, CHPC, or other healthcare compliance certification preferred.
Medicaid and Medicare credentialing and contracting experience.
Prior leadership experience managing credentialing or contracting teams.
Competitive salary: $125,000 – $175,000
Comprehensive benefits package
Growth opportunity with a rapidly expanding healthcare organization
Collaborative leadership team
Opportunity to make a meaningful impact in behavioral health and substance use disorder services
If you have a strong background in healthcare compliance, payer contracting, and credentialing and are looking to join a mission-driven organization, we'd love to hear from you.
Apply today!
