Director of Credentialing Operations

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

Jun 18, 2025 - 16:00

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