Foodsmart is hiring a Director, Credentialing and Enrollment
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About us:
Foodsmart is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Our platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. Through our highly personalized, digital platform, we guide our 2.2 million members—including those in employer-sponsored health plans, regional and national Medicaid managed care organizations, Medicare Advantage plans, and commercial insurers—on a tailored journey to eating well while saving time and money.
Foodsmart seamlessly integrates dietary assessments and nutrition counseling with online food ordering and cost-effective meal planning for the entire family, optimizing ingredients both at home and on the go. We partner with national and regional retailers across the U.S., many of whom accept SNAP/EBT, making healthier food more accessible. Additionally, we assist members with SNAP enrollment and management, providing tangible access to nutritious food. In 2024, Foodsmart secured a $200 million investment from TPG’s Rise Fund, which supports entrepreneurs dedicated to achieving the United Nations’ Sustainable Development Goals. This investment will help us expand our reach, particularly to low-income workers who are disproportionately affected by diet-related diseases.
At Foodsmart, our mission is to make nutritious food accessible and affordable for everyone, regardless of economic status. We are committed to a set of core values that shape our culture and work environment:
👥 Customer First - You start with the member and work backwards.
🚀 Make It Happen - You act with urgency, use data, and hold high standards.
🤝 One Team - You collaborate with respect and commit as a group.
Whether you're a dietitian, a commercial leader, or a technologist, working at Foodsmart means being part of a team that is passionate, supportive, and driven by a shared purpose. Join us in transforming the way people access and enjoy healthy food.
About the role:
As the Director of Credentialing & Enrollment, you will be the strategic architect and operational leader of our provider network’s eligibility. You are responsible for ensuring that every Registered Dietitian (RD) in our network is licensed, credentialed, and enrolled to provide care across all states that we operate in.
You will lead a high-performing team while partnering with Product, Engineering, and Clinical Ops to automate workflows and shorten the distance between Hired and Billing. You are the ultimate owner of our delegated credentialing agreements and our standing with CMS and private payers.
You will:Strategic Roadmap:
Define and execute the long-term vision for credentialing and enrollment, transitioning from manual processes to a tech-enabled, scalable operation.
Team Leadership:
Lead and mentor the Credentialing & Enrollment team.
Foster a culture of extreme detail-orientation and accountability.
Payer Enrollment & Strategy:
Oversee the end-to-end enrollment process for Medicare, Medicaid, and Commercial payers.
Be the primary liaison for enterprise contract activations, ensuring our network meets specific payer density and licensing/credentialing requirements.
Credentialing
Oversee initial credentialing and re-credentialing applications for registered dietitians.
Conduct ongoing monitoring of licensure, certifications, and sanctions via state licensing boards and exclusion lists, certification entities, OIG List of Excluded Individuals/Entities (LEIE), National Practitioner Data Bank (NPDB), and System for Award Management (SAM) database.
Maintain and update provider licensing, credentials, and insurance records in the credentialing database system
Track license and certification expirations for medical staff to ensure timely renewals
Delegated Credentialing:
Own and manage delegated credentialing agreements.
Lead all audit activities to ensure 100% compliance with NCQA, state Medicaid, and CMS standards.
Cross-Functional Quarterback:
Act as the operational bridge between Sales (new client launches), Clinical Quality and Operations (provider performance), and RCM (denial management related to enrollment).
Data-Driven Optimization:
Leverage data to identify bottlenecks in the licensing/enrollment funnel.
Use Excel/Sheets to track KPIs such as "Days to Enroll" and "Credentialing Pass Rates."
Leverage AI for process improvement and automation.
Compliance & Committee:
Lead the internal Credentialing Committee, presenting provider files and ensuring all primary source verifications (NPDB, OIG, SAM) are flawless.
Ensure compliance with applicable laws, regulations, procedures, and policies
Maintain knowledge of current credentialing requirements and best practices (e.g., NCQA standards)
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Salary: $160,000 - $200,000
🤖 This salary estimate is calculated by AI based on the job title, location, company, and market data. Use this as a guide for salary expectations or negotiations. The actual salary may vary based on your experience, qualifications, and company policies.
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