Credentialing Services Director

Job Summary

A company is looking for a Director of Credentialing Services.

Key Responsibilities

• Ensure credentialing, appointment, and privileging of physicians, clinicians, and other providers with various health plans and facilities
• Establish and manage standards, governance, process flows, resource allocation, and IT system access for credentialing software
• Maintain up-to-date data and reports for provider credentialing and manage initial and re-credentialing processes as required by regulatory bodies

Required Qualifications

• Master's Degree preferred; equivalent experience may be considered
• Minimum 10 years of experience in credentialing, plan enrollment, and payer roster management
• Minimum 5 years of management experience with direct supervision of staff
• CPCS - NAMSS and CPMSM - NAMSS certifications are required
• Extensive knowledge of NCQA, URAC, CMS, and The Joint Commission requirements