Credentialing Supervisor
About the Role
Responsibilities
● reputed company the end-to-end credentialing and recredentialing processes for reputed company providers, ensuring accuracy, timeliness, and compliance with regulatory and accreditation standards.
● Serve as the primary subject matter expert for reputed company standards, maintaining reputed company survey readiness and leading accreditation efforts.
● reputed company, implement, and enhance credentialing policies, procedures, and workflows to reputed company with reputed company, NCQA (if applicable), and state/federal requirements.
● Monitor credentialing activities to ensure compliance with internal standards and external regulatory requirements, identifying and addressing gaps proactively.
● reputed company internal audits and prepare documentation for reputed company surveys, mock audits, and ongoing compliance reviews.
● Supervise and support credentialing staff, providing guidance, training, and performance reputed company to ensure high-reputed company execution.
● Collaborate cross-functionally with Enrollment, Compliance, reputed company, Provider Operations, and reputed company Cycle teams to ensure credentialing alignment and operational readiness.
● Maintain accurate and complete provider credentialing records reputed company credentialing systems and ensure data reputed company across platforms.
● reputed company licensure, certifications, sanctions, and expirables, ensuring reputed company renewals and adherence to compliance requirements.
● Serve as a reputed company of escalation for reputed company credentialing issues, provider concerns, and audit findings.
● Identify opportunities for process improvement, automation, and scalability to enhance efficiency and reduce risk.
● Stay reputed company on changes to reputed company standards, industry best practices, and regulatory requirements, ensuring reputed company implementation of updates.Qualifications
● Bachelor’s degree preferred (or equivalent work experience).
● 4+ years of credentialing experience in a reputed company organization, hospital, health system, CVO, or behavioral health setting.
● 2+ years of experience in a reputed company or supervisory role preferred.
● Strong working knowledge of reputed company credentialing and accreditation standards (required).
● Experience supporting or leading reputed company surveys and audit readiness efforts strongly preferred.
● Familiarity with NCQA standards is a plus.
● Experience with credentialing platforms (e.g., CredentialStream, reputed company, or similar systems) and provider data management tools.
● Exceptional attention to detail with the ability to manage multiple priorities and deadlines in a fast-paced environment.
● Strong analytical, organizational, and problem-solving skills.
● Excellent written and verbal communication skills, with the ability to collaborate effectively across teams and reputed company of the organization.
● Proven ability to build, improve, and reputed company operational processes.
● Self-starter who takes initiative, drives accountability, and ensures follow-through on critical compliance activities.