Credentialing Director

Jobgether; United States; On-site; USD 100,000 - 120,000; Full time

Benefits offered by this job

Annual salary $100,000–$120,000 USD

Bonus programs potential

Medical insurance

Dental insurance

Vision insurance

401(k) retirement plan

Paid time off

Comprehensive benefits

Job summary

Jobgether is seeking a Credentialing Director in the United States to lead a growing credentialing and provider enrollment function. You will own operations across provider enrollment, credentialing, and re-credentialing, ensuring accuracy, regulatory compliance, and timely execution.

You will build and mentor a high-performing team, define strategy, and improve workflows using KPIs. This leadership role includes scaling infrastructure, staffing, and best practices to support national expansion.

Qualifications

• 7+ years of experience in provider relations, credentialing, provider enrollment, healthcare operations, or related field with increasing leadership responsibility.
• 4+ years of people management experience, including responsibility for multiple direct reports and/or managers.
• Strong understanding of medical billing, payer enrollment, credentialing, and healthcare workflows.
• Experience designing scalable processes, controls, and best practices.
• Bachelor’s degree required; healthcare administration or related field preferred.
• Excellent organizational, analytical, problem-solving, and reporting capabilities.

Responsibilities

• Lead credentialing department and establish responsibilities, accountability structures, and performance expectations.
• Define departmental strategy aligned to growth and service goals.
• Coach, mentor, and develop team members, manage load and career progression.
• Set and monitor KPIs: turnaround times, retention, network adequacy, NPS, error rates.
• Oversee enrollment, credentialing, and re-credentialing for accuracy and compliance.
• Ensure accurate tracking and documentation across systems and payer communications.
• Escalate complex issues to senior leadership as needed.
• Maintain SOPs, quality controls, and workflows to improve efficiency.
• Scale credentialing function as operations expand nationally.

Skills

Provider relations

Credentialing

People management

Strategic leadership

Stakeholder management

Analytical skills

Communication

Process improvement

Education

Bachelor's degree

Healthcare administration or related field preferred

Tools

Microsoft Office Suite

Credentialing systems

CAQH

Job description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Credentialing Director based in United States. The Credentialing Director will provide strategic and operational leadership for a growing healthcare credentialing and provider enrollment function. This role oversees a multidisciplinary team while establishing clear performance standards, scalable processes, and departmental priorities. You will own credentialing operations across provider enrollment, credentialing, and re-credentialing, ensuring accuracy, compliance, and timely execution. The position combines people leadership, process optimization, performance management, and cross-functional collaboration. You will use operational data and key performance indicators to identify bottlenecks, improve workflows, and strengthen service quality. As the organization expands nationally, you will play a central role in scaling infrastructure, staffing, and best practices across the credentialing function. This is an opportunity to make a direct impact in a fast-paced healthcare services environment while shaping a high-performing operational team.

Accountabilities

• Lead the credentialing department, including Provider Enrollment Specialists and Credentialing Account Managers, establishing clear responsibilities, accountability structures, and performance expectations.
• Define departmental strategy and objectives while aligning credentialing operations with broader organizational growth and service goals.
• Coach, mentor, and develop team members, overseeing performance, workload allocation, professional development, and career progression.
• Establish, monitor, and improve department-wide Key Performance Indicators (KPIs), including credentialing turnaround times, retention and turnover, network adequacy, Net Promoter Score (NPS), and error rates.
• Oversee provider enrollment, credentialing, and re-credentialing activities to ensure accuracy, timeliness, regulatory requirements, and payer compliance.
• Ensure accurate tracking, reporting, and documentation of enrollment status, payer communications, provider information, and credentialing activities across relevant systems.
• Serve as the escalation point for complex provider, payer, enrollment, or claims-related issues that require senior-level intervention.
• Maintain strong oversight of processes involving Council for Affordable Quality Healthcare (CAQH) profiles, payer applications, credentialing systems, and internal databases.
• Design, implement, and continuously improve Standard Operating Procedures (SOPs), quality controls, and workflows to increase efficiency and reduce cycle times.
• Analyze operational trends, performance metrics, bottlenecks, and capacity requirements to support strategic decision-making.
• Lead the scaling of the credentialing function as operations expand nationally, including staffing strategies, resource planning, and process infrastructure.
• Partner with client-facing credentialing leadership to ensure commitments are supported by sufficient departmental capacity and operational readiness.
• Serve as a senior liaison with Revenue Cycle, Operations, Compliance, Clinical Leadership, and other cross-functional stakeholders.
• Provide leadership with executive-level reporting on department performance, risks, capacity, priorities, and strategic initiatives.
• Represent the credentialing function in cross-functional and leadership meetings, ensuring alignment with organizational objectives.

Requirements

• 7+ years of experience in provider relations, credentialing, provider enrollment, healthcare operations, or a related healthcare services field, with progressively increasing leadership responsibility.
• 4+ years of people management experience, including responsibility for multiple direct reports and/or managers.
• Strong understanding of medical billing, payer enrollment, claims resolution, provider credentialing, and healthcare operational workflows.
• Demonstrated ability to build, lead, and develop high-performing teams while establishing accountability and performance standards.
• Proven experience designing and implementing scalable processes, operational controls, and departmental best practices.
• Bachelor’s degree required; a degree in healthcare administration, business, process improvement, or a related discipline is preferred.
• Exceptional organizational, analytical, problem-solving, and reporting capabilities, with experience presenting operational information to senior leadership.
• Strong communication and stakeholder management skills, with the ability to influence effectively across teams, functions, and organizational levels.
• Proficiency with Microsoft Office Suite and credentialing, enrollment, or provider management databases.
• Strong attention to detail and the ability to identify issues, evaluate risks, and make sound decisions in complex operational situations.
• Ability to work effectively in a fast-paced, high-growth healthcare environment with evolving priorities and competing demands.

Benefits

• Annual salary range of $100,000–$120,000 USD.
• Potential eligibility for company bonus programs in addition to base compensation.
• Medical insurance.
• Dental insurance.
• Vision insurance.
• 401(k) retirement plan.
• Paid time off.
• Comprehensive benefits package with additional employee benefits.
• Opportunity to lead and scale a critical healthcare operations function.
• High-impact leadership role with significant ownership over strategy, people, processes, and performance.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.