Director of Credentialing

Job Summary

A company is looking for a Director of Credentialing.

Key Responsibilities

• Provide strategic leadership for credentialing, recredentialing, privileging, and provider enrollment activities
• Oversee verification processes and ensure compliance with regulatory and payer requirements
• Manage external vendor relationships and optimize credentialing workflows and technology

Required Qualifications

• Bachelor's degree in healthcare administration, business, or related field
• 7 or more years of credentialing experience in a healthcare organization
• 3 or more years of leadership or management experience
• Strong knowledge of CMS, Joint Commission, NCQA, URAC, and payer credentialing requirements
• Proficiency with credentialing software systems and digital document management