Credentialing and Privileging Specialist

thejanepauleycommunityhealthcenterinc; Indianapolis (IN); On-site; USD 55,000 - 85,000; Full time

Job summary

Jane Pauley Community Health Center is seeking a Credentialing and Privileging Specialist to oversee onboarding, credentialing, privileging, and ongoing monitoring for licensed practitioners and APPs across Indiana.

Reporting to the Chief Human Resources Officer, you will manage initial credentialing, re-credentialing, and privileging in line with HRSA requirements and accreditation standards, while coordinating with Clinical Leadership and Compliance to ensure timely, compliant provider

Responsibilities

• Coordinate provider and clinical staff onboarding from offer acceptance through first day of patient care, aligned with HR hiring and onboarding processes.
• Partner with Talent Acquisition, Compliance, IT, Clinical Operations, Revenue Cycle, and site leadership to ensure all onboarding steps are completed, including background checks, health screenings, trainings, EHR access, badging, orientation, and competency validations.
• Confirm that no provider begins independent patient care until credentialing, privileging, and onboarding requirements are fully met.
• Maintain onboarding checklists, identify bottlenecks, and drive timely completion to support provider start dates.
• Process initial credentialing applications for all providers in accordance with organizational policies, HRSA requirements, and applicable accreditation standards.
• Manage the re-credentialing cycle, ensuring every provider is re-credentialed and re-privileged on schedule.
• DEA and state-controlled substance registrations, work history, malpractice history, and hospital affiliations or admitting arrangements.
• Query NPDB, OIG List, SAM.gov, and state Medicaid/Medicare exclusion databases at appointment, re-credentialing, and ongoing.
• Follow up on gaps or adverse findings and escalate to CHRO/CMO/compliance leadership.
• Maintain accurate, complete credentialing and privileging files.
• Coordinate the delineation of clinical privileges with the CMO and clinical leaders, based on training and competence.
• Prepare provider files for review by the CMO, Credentialing Committee, and Governing Board.
• Track FPPE/OPPE, performance reviews, and peer review documentation for re-privileging.
• Manage temporary privileges and close-out documentation.
• Maintain FTCA and HRSA credentialing compliance and support OSV, audits, and corrective action.

Job description

Empowering communities through accessible, inclusive, and compassionate care, this is the work we do every day.

At Jane Pauley Community Health Center , every role is connected to something bigger. As a Federally Qualified Health Center (FQHC), we deliver integrated, whole-person care to individuals and families across Indiana, regardless of income or insurance status.

Our teams work at the intersection of clinical excellence and community impact, supporting underserved populations while building a culture rooted in collaboration, respect, and growth. Here, you are not just joining a workplace, you are becoming part of a mission that truly matters.

Position Summary

Reporting to the Chief Human Resources Officer, the Credentialing and Privileging Specialist ensures that all licensed independent practitioners and advanced practice providers, including physicians, nurse practitioners, physician assistants, dentists, behavioral health clinicians, and other clinicians, are properly onboarded, privileged, and credentialed before providing patient care. The specialist manages the full provider lifecycle: initial credentialing, privileging, re-credentialing, onboarding, and ongoing monitoring. The role supports compliance with HRSA Health Center Program requirements, FTCA deeming standards, accreditation standards, and payer requirements. The specialist works in close partnership with the Chief Medical Officer and clinical leadership, who holds authority over clinical privileging decisions, and reports credentialing and onboarding status to senior and executive leaders.

Key Responsibilities

Onboarding

Coordinate and track provider and clinical staff onboarding from offer acceptance through first day of patient care, in alignment with HR hiring and onboarding processes.

Partner with Talent Acquisition, Compliance, IT, Clinical Operations, Revenue Cycle, and site leadership to ensure all onboarding steps are completed. These include, for example, employment verification, background checks, health screenings and immunizations, required trainings, EHR access, badging, orientation, and competency validations.

Confirm that no provider begins independent patient care until credentialing, privileging, and onboarding requirements are fully met.

Maintain onboarding checklists, identify bottlenecks, and drive timely completion to support provider start dates.

Credentialing and Re-credentialing

Process initial credentialing applications for all providers in accordance with organizational policies, HRSA requirements, and applicable accreditation standards.

Manage the re-credentialing cycle, ensuring every provider is re-credentialed and re-privileged on schedule (at least every two years for FTCA-covered providers, or per organizational policy and accreditation requirements).

DEA and state-controlled substance registrations, work history, malpractice history, and hospital affiliations or admitting arrangements.

Query the National Practitioner Data Bank (NPDB), OIG List of Excluded Individuals/Entities, SAM.gov, and state Medicaid and Medicare exclusion databases at appointment, at re-credentialing, and on a continuous or monthly basis.

Follow up on gaps, discrepancies, or adverse findings and escalation concerns promptly to the CHRO, CMO, and compliance leadership.

Maintain accurate, complete, and confidential credentialing and privileging files.

Privileging

Coordinate the delineation of clinical privileges with the CMO and clinical leaders, based on training, experience, and demonstrated competence, aligned with the scope of services in the health center's HRSA-approved scope of project.

Prepare provider files for review and approval by the CMO, Credentialing Committee, and Governing Board (or per bylaws).

Track focused and ongoing professional practice evaluations (FPPE/OPPE), performance reviews, and peer review documentation required for re-privileging, obtaining clinical input from the CMO and designated peer reviewers.

Manage temporary privileges, ensuring proper documentation and timely close-out.

FTCA and HRSA Compliance

Maintain credentialing and privileging files that meet FTCA deeming requirements and HRSA's Policy Information Notice (PIN) on credentialing and privileging.

Support the annual FTCA deeming application and renewal process, including provider data and documentation.

Assist with HRSA Operational Site Visits (OSV), audits, and corrective action plans related to credentialing, privileging, and onboarding.

Track compliance with applicable Joint Commission, AAAHC, or NCQA standards, as well as state and federal regulations.

Monitoring and Tracking

Track expiration dates for licenses, certifications (e.g., BLS, ACLS), DEA registrations, malpractice or FTCA coverage, and other time-sensitive credentials, and send timely reminders to providers and managers.

Maintain a master tracking system across all sites and provider types, with proactive alerts for upcoming expirations and re-cred