Credentialing Specialist

VITRA Health•Boston, MA

About The Position

As the Credentialing Specialist, you will ensure that all caregivers are properly onboarded and credentialed with the organization in compliance with state and federal regulations. This role also manages the organization’s payor credentialing, including enrollment, re-credentialing, and compliance with Medicaid, insurance, and other funding sources. The Credentialing Specialist plays a critical role in supporting the delivery of high-quality care and services to clients by ensuring caregivers are fully qualified, trained, and compliant, and that organizational standards meet regulatory and payor requirements. The ideal candidate is mission-minded, detail-oriented, organized. They must be able to manage sensitive information with discretion and integrity, while ensuring audit readiness and multi-state compliance.

Requirements

High school diploma or equivalent required; associate or bachelor’s degree in healthcare administration, human resources, or a related field preferred.
Experience in credentialing, compliance, or healthcare administration preferred.
Knowledge of adult foster care and group adult foster care regulations, caregiver credentialing, and organizational payor credentialing (Medicaid/insurance/funding sources) across multiple states preferred.
Strong organizational skills and meticulous attention to detail.
Excellent written and verbal communication skills.
Proficiency with Microsoft Office Suite and experience with credentialing, electronic medical records, or HRIS software.
Strong organizational, analytical, and communication skills.
Ability to manage confidential and sensitive information with integrity and discretion.
Potential for occasional travel between office locations, especially during external audits or inspections.
Show genuine interest and compassion for the communities we serve and commitment to the diversity of our clients and team members.

Responsibilities

Oversee the onboarding and credentialing process for caregivers, ensuring all caregivers meet organizational standards, regulatory requirements, and can provide high-quality support for clients.
Conduct comprehensive background checks, including, but not limited to criminal history, Office of Inspector General exclusions and sanctions, employment verification.
Verify caregiver eligibility and qualifications, included any relevant licenses, certifications, and other organizational requirements.
Track completion status of mandatory trainings and continuing education and monitor expirations for timely renewals.
Maintain accurate, organized, and audit-ready credentialing records for caregivers.
Manage the organization’s payor credentialing, including initial enrollment, re-credentialing, and ongoing compliance with Medicaid, insurance, and other funding sources.
Ensure all caregiver and organizational data is handled with discretion, confidentiality, and integrity.
Serve as a primary point of contact for caregivers and internal teams regarding credentialing requirements and documentation.
Monitor and stay informed on state-specific adult foster care regulations and payor requirements to ensure ongoing compliance.
Support internal and external audits, ensuring all records and processes are inspection-ready.
Ensure credentialing processes follow organizational policies and standard operating procedures (SOPs).
Assist with reporting on caregiver credentialing and organizational payor compliance metrics to leadership or regulatory agencies.
Identify opportunities to improve credentialing processes for efficiency, accuracy, consistency, and to support high-quality client care.
Foster culture of customer service and commitment to quality care.
Serve as a brand ambassador for Vitra reflecting our vision, mission, and values.

Benefits

Employer sponsored health Insurance with a generous employer match.
Dental and Vision Benefits.
Supplemental Benefits
Life, Accident, Critical Illness and Disability Insurance.
401K with a 5% company match.
Accrued Paid-Time-Off.
Ten company paid holidays.
Wellness Benefits.
Tuition Reimbursement.
Supportive team structure and company culture with a focus on work/life balance.