Credentialing, Privileging & Enrollment Supervisor

Wellspace Health; Sacramento (CA); On-site; USD 95,680 - 108,500; Full time

Benefits offered by this job

Health benefits

Life insurance

Long-term disability insurance

Retirement plan match

Job summary

WellSpace Health in Sacramento, CA is seeking a Credentialing, Privileging & Enrollment Supervisor to oversee the full lifecycle of provider credentialing, recredentialing, and privileging for clinical staff. This role ensures regulatory compliance with California rules, HRSA FTCA, Medicare/Medicaid enrollment, and NCQA/Joint Commission standards.

The supervisor will lead credentialing staff, manage workflows, ensure data accuracy, and collaborate with leadership, providers, and external

Qualifications

• Bachelor’s degree in business or healthcare administration or related field, or 5 years’ experience in hospital and/or healthcare credentialing in lieu of education
• Preferred Medical Staff Services certification: CPMSM, CPCS, or CPMSM from NAMSS
• Knowledge of credentialing rules, regulations, and accrediting organization standards
• Experience with audits from TJC, FTCA, plans/IPA, etc.

Responsibilities

• Oversee the credentialing & privileging process to ensure qualified individuals provide patient care based on training, licensure, and experience.
• Supervise the Credentialing & Enrollment team to ensure optimal department performance.
• Act as subject matter expert for credentialing, privileging, and enrollment within Human Resources.
• Ensure compliance with rules, regulations, policies, and regulatory agency standards.
• Audit and evaluate verification processes for licensed and certified providers and allied health professionals' applications and privilege delineation.
• Coordinate processing of credentialing & privileging applications, ensuring timely and complete compliance with HR guidelines.

Skills

Communication skills

Leadership

Analytical skills

Organization

Education

Bachelor’s degree in business or healthcare administration

5+ years credentialing experience (in lieu of education)

Job description

Job Details

Location: 164 - 1500 Expo Parkway, Sacramento, CA 95815

Salary Range: $95,680.00 - $108,500.00 per year

Job Title: Credentialing, Privileging & Enrollment Supervisor

Role: Human Resources & Clinical Staff Office, Full‑Time, Exempt

Organization Information

WellSpace's mission is "achieving regional health through high quality comprehensive care." We believe that everyone deserves to be seen, no matter who you are, where you come from, or what place you call home, and we serve the whole person through integrated care across medical, dental, behavioral health, and supportive services.

WellSpace is the region's largest Community Health System, utilizing a Confluence Model to integrate Federally Qualified Health Centers, Certified Community Behavioral Health Centers, and more into seamless care. Accredited by the Joint Commission for Ambulatory Care, Behavioral Health, and as a CCBHC, and certified as a Primary Care Medical Home and Behavioral Health Home.

Position Summary

The Credentialing & Privileging Supervisor oversees the full lifecycle of provider credentialing, recredentialing, and privileging for licensed, certified, and other clinical staff. The role ensures compliance with California regulations, HRSA FTCA requirements, Medicare/Medicaid enrollment, payer credentialing, and NCQA/Joint Commission standards. The supervisor leads credentialing staff, manages workflows, ensures data accuracy, and collaborates with leadership, providers, and external agencies.

Required Qualifications

• Bachelor’s degree in business or healthcare administration or related field, or 5 years’ experience in hospital and/or healthcare credentialing in lieu of education
• Preferred Medical Staff Services certification: Certified Professional Medical Services Management (CPMSM), Certified Provider Credentialing Specialist (CPCS), or CPMSM from NAMSS
• Knowledge of credentialing rules, regulations, and accrediting organization standards, including CMS, state regulations, and other agencies
• Experience with audits from TJC, FTCA, plans/IPA, etc.
• Minimum five (5) years of supervisory or lead experience in credentialing
• Ability to supervise up to 5 employees
• Experience working in a Human Resources department
• Excellent communication skills in English, both verbal and written; fluency in additional languages preferred
• Excellent interpersonal, analytical, and organizational skills
• Knowledge of basic anatomy and physiology, medical terminology, and medical staff services functions
• Advanced computer skills in word processing, spreadsheets, and databases
• Willingness to successfully complete the credentialing process

Essential Responsibilities

• Oversee the credentialing & privileging process to ensure qualified individuals provide patient care based on training, licensure, and experience.
• Supervise the Credentialing & Enrollment team to ensure optimal department performance.
• Act as subject matter expert for credentialing, privileging, and enrollment within Human Resources.
• Ensure compliance with rules, regulations, policies, and regulatory agency standards.
• Audit and evaluate verification processes for licensed and certified providers and allied health professionals' applications, reappointments, and privilege delineation.
• Coordinate processing of credentialing & privileging applications, ensuring timely and complete compliance with HR guidelines.
• Audit applications and review supporting documents, including primary source verification, to keep files current and policies followed.
• Coordinate activities, provide statistical information, and explain procedures to facilitate the reappointment process.
• Maintain and monitor confidential information for credentialing, HR, and peer review discussions.
• Organize and support the Credentialing Committee.
• Report findings, conclusions, and recommendations for appointment or reappointment actions to leadership, and ensure approved actions are implemented in a timely manner.
• Improve professional growth and job knowledge through professional organizations, seminars, and journals.
• Develop and implement policies and procedures that guide and support service delivery.
• Apply knowledge of state and federal laws regarding due process and HIPAA provisions.
• Support and maintain a culture of safety and quality.
• Perform other duties as assigned.

Benefits

Successful candidate will receive regionally competitive salary, above‑average health benefits at reduced costs, company‑paid life insurance & long‑term disability insurance, additional voluntary retirement plan with company match and no vesting schedule requirement, dependent on working 30+ hours per week.

• Paid bereavement and jury duty leave
• 11 paid holidays per year
• Paid time off
• Paid sick leave
• Flexible Spending Program
• Professional development hours offered annually

Physical Demands and Work Environment

The work environment is characteristic of a medical clinic. The employee frequently sits; uses hands and arms to reach, stands, walks, and lifts up to 20 pounds. Vision abilities required include close and distance vision, and hearing and speech for in‑person and telephone communication. The noise level is usually quiet. The employee may encounter individuals in crisis, exposure to bodily fluids and hazardous chemicals, and sensory demands related to substance use or lack of personal care. Specific vision, hearing, and communication skills are required to interact with patients and colleagues.

Equal Employment Opportunity Statement

WellSpace Health is committed to the principles of equal employment. We comply with all federal, state, and local laws providing equal employment opportunities, and we maintain a work environment free of harassment, discrimination, or retaliation for any protected status. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. WellSpace Health is an Equal Opportunity Employer.