Director of Contracting & Credentialing

SOUTH COAST COMMUNITY SERVICES•Mission Viejo, CA

About The Position

POSITION SUMMARY: The Director of Contracting & Credentialing provides leadership and oversight to ensure SCCS’s providers, services, and organizational entities are accurately credentialed, enrolled, and represented across commercial payers, managed care organizations, and County Medi-Cal systems as the organization expands across multiple states. Reporting to the Chief Marketing & Development Officer, with a dotted line to the CFO, this role serves as the central authority for credentialing, enrollment, directory accuracy, payer system integrity, and contract tracking. The Director brings established relationships with senior leaders across commercial insurers, MCOs, and County Medi-Cal and ensures continuity, accuracy, and accountability in all contracting and credentialing-related activities.

Requirements

Bachelor’s degree required; Master’s preferred.
8–10+ years of progressive experience in provider credentialing, payer enrollment, and managed care environments.
Demonstrated experience leading credentialing functions and performing hands-on credentialing work.
Strong working knowledge of CAQH, Availity, PAVE, and payer and MCO portals.
Experience supporting multi-state healthcare organizations.
Established professional relationships with senior leaders across commercial payers, managed care organizations, and County Medi-Cal systems.
Valid CA driver’s license and proof of automobile insurance.

Nice To Haves

Credentialing certification such as CPCS or CPMSM, preferred.
Experience in behavioral health or community-based healthcare settings, preferred.
Experience building and maintaining contract and credentialing tracking systems, preferred.