Credentialing Director: Compliance, Ops & Leadership

PROGYNY; United States; On-site; USD 130,000 - 145,000; Full time

Benefits offered by this job

Family benefits

Mental health support

Equity and bonus program

401(k) with company match

Onsite meals

Job summary

Progyny is seeking a Credentialing Leader to oversee direct and delegated credentialing, ensuring regulatory compliance and high standards for provider networks.

The role drives credentialing workflows, maintains the credentialing database, and develops tools and policies while hiring and supervising staff. You will partner with HR, compliance, and leadership to mitigate risks and improve processes.

Qualifications

• Leadership experience in a credentialing setting with team management.
• Familiarity with Joint Commission, NCQA, CMS rules and state/federal rules.
• Experience with delegated credentialing oversight and audits.
• Proficiency with credentialing software and reporting tools.
• Ability to create and govern policies, workflows and metrics.
• Discretion with confidential peer review information.
• Ability to meet deadlines for committee work.

Responsibilities

• Oversees direct and delegated credentialing processes.
• Ensures accreditation and regulatory compliance.
• Leads credentialing operations: database, workflows, reports, policies.
• Hires and supervises staff; coordinates with leaders.
• Supports compliance reviews, audits, and site reviews.
• Defines KPI/SLAs and drives ongoing improvement.
• Serves as escalation point for providers and HR/compliance.

Skills

People leadership

Regulatory knowledge

Credentialing oversight

Data quality discipline

Policy & workflow development

Change management

Meeting coordination

Education

Bachelor's degree preferred

CPMSM/CPCS required

Tools

Credentialing software/CVOs

Databases & reporting tools

Job description

Progyny is seeking a Credentialing Leader to oversee direct and delegated credentialing, ensuring regulatory compliance and high standards for provider networks.

The role drives credentialing workflows, maintains the credentialing database, and develops tools and policies while hiring and supervising staff. You will partner with HR, compliance, and leadership to mitigate risks and improve processes.