Director of Credentialing

Job Summary

A company is looking for a Director of Credentialing and Enrollment.

Key Responsibilities

• Define and execute the strategic roadmap for credentialing and enrollment, transitioning to a tech-enabled operation
• Lead and mentor the Credentialing & Enrollment team, fostering a culture of detail-orientation and accountability
• Oversee the enrollment process for Medicare, Medicaid, and Commercial payers, ensuring compliance with licensing and credentialing requirements

Required Qualifications

• 7+ years in healthcare operations with 3+ years in a leadership role focused on Credentialing and Payer Enrollment
• Experience managing multi-state licensure and enrollment for a distributed provider network
• Deep knowledge of NCQA standards and CMS regulations
• Intermediate to advanced skills in Excel/Google Sheets and experience with credentialing software
• Bachelor's degree required; CPCS or CPMSM certification is a plus