Director of Credentialing Operations

Job Summary

A company is looking for a Director of Credentialing Operations to lead provider credentialing and health plan enrollment functions.

Key Responsibilities

• Oversee the end-to-end credentialing process, ensuring accuracy and compliance
• Manage provider enrollment with Medicaid and commercial payers, meeting documentation requirements
• Identify and implement operational improvements and automation in credentialing workflows

Required Qualifications

• 5-7 years of experience in healthcare credentialing or provider enrollment
• Strong knowledge of state licensing requirements, particularly Medicaid regulations
• Experience managing high-volume operational processes
• Proven ability to implement or improve credentialing systems and automation tools
• Data-driven mindset with the ability to analyze and report on performance metrics