Senior Credentialing & Regulatory Operations Lead

Circle Medical; United States; On-site; USD 73,000 - 81,000; Full time

Benefits offered by this job

Paid Time Off

Health & Insurance

Wellness programs

Retirement plan with company match

Professional development reimbursement

Job summary

Circle Medical is a virtual-first primary care organization hiring a Credentialing and Regulatory Operations Manager in the United States. You will lead provider credentialing, licensing, and privileging programs, manage staff, and ensure compliance with CMS, NCQA, and payer requirements while coordinating with Compliance and Legal teams.

You will oversee workflows, drive accuracy, maintain supervising physician agreements, and optimize operational metrics across credentialing cycles, renewals,

Qualifications

• Bachelor’s degree in healthcare administration, business administration, or related field.
• 3+ years of progressive provider credentialing, licensing, or medical staff services experience.
• 2+ years of supervisory or management experience.
• In-depth knowledge of NCQA, Joint Commission, CMS credentialing standards.
• Strong leadership and communication skills.
• Proficiency in credentialing software and Google applications.

Responsibilities

• Own end-to-end credentialing, re-credentialing, supervising physician management, privileging, and licensing.
• Ensure compliance with CMS, NCQA, Joint Commission, and payer requirements.
• Manage primary source verification of education, training, licensure, board certification, DEA, sanctions, and work history.
• Maintain supervising physician relationships and agreements.
• Collaborate with Compliance, Legal, Revenue Cycle, Provider Operations, and Clinical Leadership.
• Coordinate credentialing information for payer enrollment, revalidation, and re-credentialing.

Skills

Provider credentialing

Licensing requirements

Leadership & supervision

Communication

Regulatory compliance

Data accuracy

Google applications

Education

Bachelor’s degree in healthcare administration or related field

CPCS or CPMSM certification

Tools

Modio

Symplr

Helix

Job description

Circle Medical is a virtual-first primary care organization hiring a Credentialing and Regulatory Operations Manager in the United States. You will lead provider credentialing, licensing, and privileging programs, manage staff, and ensure compliance with CMS, NCQA, and payer requirements while coordinating with Compliance and Legal teams.

You will oversee workflows, drive accuracy, maintain supervising physician agreements, and optimize operational metrics across credentialing cycles, renewals,