Director of Credentialing

Job Summary

A company is looking for a Director of Credentialing and Enrollment to lead credentialing operations and ensure compliant onboarding of clinicians.

Key Responsibilities

• Oversee the full credentialing and recredentialing process for clinicians across multiple states and payer networks
• Lead and mentor a credentialing team to support onboarding and geographic expansion
• Develop and maintain credentialing policies and procedures in alignment with regulatory guidelines

Qualifications

• Bachelor's degree required; CPCS, CPMSM, or equivalent certification preferred
• 7+ years of experience in healthcare credentialing, with at least 3 years in a leadership role
• Strong knowledge of behavioral health credentialing and payer enrollment processes
• Experience with delegated credentialing relationships and managing audits
• Familiarity with credentialing platforms such as Modio or MD-Staff