Credentialing Supervisor

AtWork!; Sacramento (CA); On-site; USD 86,000 - 90,000; Full time

Job summary

AtWork! is seeking an experienced Credentialing, Privileging & Enrollment Supervisor in Sacramento, CA.

This role leads the full lifecycle of credentialing, recredentialing, privileging, and enrollment for licensed and allied professionals, ensuring accuracy, compliance, and timely processing. The ideal candidate has extensive healthcare credentialing expertise and proven supervisory abilities, with a focus on confidentiality and high-quality standards.

Qualifications

• Bachelor's degree or five years credentialing experience in lieu of degree.
• Five years of supervisory or lead credentialing experience.
• Experience supervising a team of up to five staff.
• Strong knowledge of healthcare credentialing regulations and standards.

Responsibilities

• Supervise the Credentialing & Enrollment team to ensure productivity and accuracy.
• Oversee credentialing, recredentialing, privileging, and enrollment processes.
• Ensure compliance with California and federal requirements including Medicare/Medicaid enrollment.
• Audit credentialing files and verify supporting documentation.
• Monitor workflows and implement process improvements for efficiency.
• Coordinate credentialing committee activities and provider appointments.
• Maintain confidential credentialing and HR information.
• Collaborate with leadership to resolve credentialing issues.

Skills

Supervisory experience

Credentialing knowledge

Regulatory compliance

HIPAA knowledge

Audit experience

Education

Bachelor's degree in Business Administration/Healthcare Administration or related field

Five years credentialing experience in healthcare

Tools

Microsoft Word

Excel

Databases

Job description

Credentialing, Privileging & Enrollment Supervisor

Location: Sacramento, CA

Salary: $87, 360 per year

Schedule: Full-Time

Exempt Position Overview

We are seeking an experienced Credentialing, Privileging & Enrollment Supervisor to lead provider credentialing and enrollment operations within a healthcare organization. This role oversees the full lifecycle of credentialing, recredentialing, privileging, and enrollment for licensed, certified, and other clinical professionals, ensuring regulatory compliance, accurate documentation, and timely processing. The ideal candidate brings strong healthcare credentialing expertise, proven supervisory experience, and the ability to manage a team while maintaining high standards of quality, confidentiality, and compliance.

Key Responsibilities

• Supervise and support the Credentialing & Enrollment team, ensuring productivity, accuracy, and timely completion of assignments.
• Oversee provider credentialing, recredentialing, privileging, and enrollment processes.
• Ensure compliance with California regulations, federal requirements, Medicare/Medicaid enrollment, payer credentialing, and applicable accreditation standards.
• Audit credentialing applications, supporting documentation, and primary source verifications to ensure files remain current and complete.
• Monitor workflows, identify process improvements, and implement policies and procedures to support departmental efficiency.
• Coordinate credentialing committee activities and support provider appointment and reappointment processes.
• Maintain confidential credentialing, Human Resources, and peer review information.
• Collaborate with leadership, providers, and external agencies to resolve credentialing issues and maintain compliance.
• Monitor quality standards and ensure credentialing activities are completed in accordance with established guidelines.

Required Qualifications

• Bachelor' s degree in Business Administration, Healthcare Administration, or a related field; OR five years of hospital and/or healthcare credentialing experience in lieu of a degree.
• Minimum of five years of supervisory or lead experience in credentialing.
• Experience supervising staff, with the ability to oversee a team of up to five employees.
• Experience working within a Human Resources department.
• Strong knowledge of healthcare credentialing regulations, accreditation standards, and requirements applicable to medical staff and allied health professionals.
• Experience with audits involving The Joint Commission (TJC), Federal Tort Claims Act (FTCA), health plans, and/or Independent Practice Associations (IPAs).
• Knowledge of Medicare and Medicaid requirements, state and federal regulations, and HIPAA.
• Familiarity with medical terminology, basic anatomy and physiology, and medical staff services.
• Advanced computer skills, including word processing, spreadsheets, and databases.
• Excellent organizational, communication, interpersonal, and problem-solving skills.

Preferred Qualifications

• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) credential through the National Association Medical Staff Services (NAMSS).
• Fluency in additional languages.