Strategic Credentialing & Licensing Operations Director

US Oral Surgery Management; Irving (TX); On-site; USD 150,000 - 210,000; Full time

Job summary

US Oral Surgery Management seeks a Director of Provider Credentialing & Licensing Operations to ensure oral surgeons are properly licensed and credentialed across states. The role partners with a credentialing vendor, builds delegated credentialing, and ensures compliance with NCQA standards.

You will lead a team of four, manage vendor relationships, KPIs, and SLAs, and develop new workflows for onboarding, licensing, and payer enrollment to enable timely, in-network credentialing and improved

Qualifications

• Bachelor’s degree in healthcare administration, business or related field.
• 8+ years of experience in provider credentialing, licensing or payer enrollment in dental, medical or healthcare setting.
• 5+ years managing people.
• Experience partnering with outsourced credentialing vendor to build processes/workflows.
• Hands-on experience building or running a delegated credentialing program with policies and audits.
• Knowledge of state licensing, permit and compliance requirements.

Responsibilities

• Vendor partnership and process design with credentialing vendors.
• Oversee delegated credentialing program with payers including governance and audits.
• Lead a team of four with licensing, credentialing oversight, compliance and reporting.
• Design workflows for surgeon onboarding, licensing, hospital privileges and payer enrollment.
• Maintain staffing plan and budget; scale workflows as practices grow.
• Provide training and communications to executives, surgeons and practice leaders.

Skills

Leadership

Vendor management

Process design

Data reporting

Communication

Education

Bachelor’s degree in healthcare administration, business or related field

Tools

ServiceNow

Zendesk

Jira

Power BI

Job description

US Oral Surgery Management seeks a Director of Provider Credentialing & Licensing Operations to ensure oral surgeons are properly licensed and credentialed across states. The role partners with a credentialing vendor, builds delegated credentialing, and ensures compliance with NCQA standards.

You will lead a team of four, manage vendor relationships, KPIs, and SLAs, and develop new workflows for onboarding, licensing, and payer enrollment to enable timely, in-network credentialing and improved