Director of Credentialing

USA Clinics Group; Northbrook (IL); On-site; USD 90,000 - 115,000; Full time

Benefits offered by this job

Health

Dental

Vision

401k & Match

Paid time off

Job summary

USA Clinics Group is seeking a Director of Credentialing located in Northbrook, IL, responsible for overseeing provider credentialing and payer enrollment processes. The role emphasizes compliance and operational efficiency.

The ideal candidate will need a Bachelor’s degree, 7+ years of related experience, and proven success in leadership within multi-state operations. Compensation ranges between $90,000 and $115,000 annual salary along with comprehensive health benefits, a retirement plan, and paid time off.

Qualifications

• Minimum 7 years of credentialing and payer enrollment experience, with at least 3 years in a leadership role.
• Extensive knowledge of CAQH, recredentialing, and compliance requirements.
• Proven success leading department improvements and operational scalability.

Responsibilities

• Oversee all provider credentialing and payer enrollment activities.
• Develop and monitor credentialing KPIs and department performance metrics.
• Implement AI-powered workflows to reduce turnaround times.

Skills

Provider credentialing

Payer enrollment

Regulatory compliance

Multi-state credentialing operations

AI-driven efficiencies

Education

Bachelor’s degree in Healthcare Administration or related field

Job description

Position Summary:

The Director of Credentialing provides strategic oversight of provider credentialing, payer enrollment, compliance, and onboarding operations. This role leads department performance, process standardization, AI-driven efficiencies, and initiatives that support organizational growth and scalability.

Position Details:

• Location: Northbrook, IL
• Schedule: Full-time, Monday through Friday on-site.
• Compensation: $90,000 - $115,000

Key Responsibilities

• Oversee all provider credentialing, payer enrollment, recredentialing, and compliance activities across the organization.
• Develop and monitor credentialing KPIs, provider onboarding timelines, enrollment aging reports, and department performance metrics.
• Lead initiatives to improve provider onboarding speed, enrollment accuracy, and regulatory compliance.
• Establish standardized credentialing processes, SOPs, and quality assurance measures across all markets.
• Partner with operations, recruiting, compliance, and clinical leadership to support provider onboarding and expansion initiatives.
• Lead credentialing system improvements, vendor management, and department optimization projects.
• Serve as the strategic operational leader responsible for credentialing efficiency, scalability, and compliance.

AI & Automation Responsibilities

• Implement AI-powered provider onboarding workflows to reduce credentialing turnaround times.
• Develop automated license, certification, and recredentialing tracking systems.
• Utilize AI to analyze enrollment bottlenecks and identify process improvement opportunities.
• Lead adoption of automation tools that streamline payer enrollment, document management, and compliance reporting.

Minimum Requirements

• Bachelor’s degree in Healthcare Administration, Business Administration, or related field required.
• Minimum 7 years of credentialing and payer enrollment experience, with at least 3 years in a leadership role.
• Extensive knowledge of provider credentialing, payer enrollment, CAQH, recredentialing, and regulatory compliance requirements.
• Experience managing multi-state provider credentialing operations and onboarding programs.
• Proven success leading department improvements, workflow standardization, and operational scalability initiatives.

• Health
• Dental
• Vision
• 401k & Match
• Paid time off