Director of Credentialing

Naphcare, Inc.•Vestavia Hills, AL

23h•Onsite

About The Position

NaphCare is seeking to hire a Director of Credentialing to join our team at our Corporate Headquarters located in Birmingham, AL. This is an on-site position in Birmingham, AL. The Director of Credentialing is responsible for the overall leadership, management, and strategic direction of the credentialing and privileging process across the organization. This role ensures that all healthcare providers practicing within correctional facilities (prisons and jails) meet applicable state, federal, and contractual requirements, as well as internal standards of excellence. The Director will oversee provider credentialing, recredentialing, privileging, and compliance monitoring to ensure uninterrupted access to high-quality healthcare services.

Requirements

Bachelor’s degree in Healthcare Administration, Nursing, or related field required; Master’s degree preferred.
Minimum of 7–10 years of experience in credentialing, with at least 3–5 years in a leadership role.
Strong knowledge of NCCHC, as well as state-specific licensing requirements.
Excellent organizational, communication, and leadership skills.
Ability to work collaboratively with cross-functional teams and manage multiple priorities in a fast-paced environment.

Nice To Haves

CPCS or CPMSM certification preferred.
Experience with correctional healthcare strongly preferred.

Responsibilities

Direct and manage the credentialing department, including staff supervision, training, and performance management.
Develop and implement credentialing policies, procedures, and workflows in alignment with NCCHC, state medical boards, and contractual requirements.
Oversee initial credentialing, recredentialing, and privileging for physicians, nurse practitioners, physician assistants, pharmacists, behavioral health providers, and other licensed staff.
Ensure timely and accurate processing of provider applications, verifications, and committee approvals to support recruitment and onboarding.
Partner with Medical Directors and corporate leadership to maintain up-to-date provider rosters and ensure compliance with supervisory and collaborative agreement requirements across states.
Monitor compliance with federal and state regulations governing provider credentialing in correctional settings.
Maintain readiness for audits by government agencies, accrediting bodies, and correctional system partners.
Ensure adherence to payer credentialing and managed care requirements, when applicable.
Serve as the primary liaison between Operations, HR, Recruiting, and Clinical leadership regarding credentialing status and timelines.
Provide clear reporting on credentialing metrics, risk areas, and provider readiness to support staffing in facilities.
Support site-level Medical Directors in understanding credentialing requirements and managing collaborative agreements.
Evaluate credentialing processes for efficiency, compliance, and best practices; lead continuous improvement initiatives.
Leverage credentialing software systems to track applications, expirables, and reporting requirements.
Implement consistent credentialing standards across multiple states and facilities.