Director of Credentialing

Job Summary

Leading the charge in credentialing operations, the full-time Director of Credentialing will ensure compliance with regulatory standards while managing provider credentialing, privileging, and payer enrollment activities in a remote environment.

Key responsibilities:

• Direct credentialing and payer enrollment departments, establishing strategic goals and performance standards
• Act as the subject matter expert on provider credentialing and insurance regulations, ensuring compliance and optimizing workflows
• Build and manage a high-performing team through effective hiring, training, and performance management

Required qualifications:

• 7+ years of experience in credentialing and/or payer enrollment, including 3+ years in a leadership role
• Strong knowledge of federal and state regulations, including NCQA and The Joint Commission standards
• Experience with CAQH, NPPES, PECOS, and payer credentialing portals
• Proven ability to manage teams and drive operational efficiency on a national scale
• Analytical mindset with experience in process improvement and data manipulation