Director of Credentialing

USA Clinics Group•Northbrook, IL

9d•Onsite

About The Position

The Director of Credentialing provides strategic oversight of provider credentialing, payer enrollment, compliance, and onboarding operations. This role leads department performance, process standardization, AI-driven efficiencies, and initiatives that support organizational growth and scalability.

Requirements

Bachelor’s degree in Healthcare Administration, Business Administration, or related field required.
Minimum 7 years of credentialing and payer enrollment experience, with at least 3 years in a leadership role.
Extensive knowledge of provider credentialing, payer enrollment, CAQH, recredentialing, and regulatory compliance requirements.
Experience managing multi-state provider credentialing operations and onboarding programs.
Proven success leading department improvements, workflow standardization, and operational scalability initiatives.

Responsibilities

Oversee all provider credentialing, payer enrollment, recredentialing, and compliance activities across the organization.
Develop and monitor credentialing KPIs, provider onboarding timelines, enrollment aging reports, and department performance metrics.
Lead initiatives to improve provider onboarding speed, enrollment accuracy, and regulatory compliance.
Establish standardized credentialing processes, SOPs, and quality assurance measures across all markets.
Partner with operations, recruiting, compliance, and clinical leadership to support provider onboarding and expansion initiatives.
Lead credentialing system improvements, vendor management, and department optimization projects.
Serve as the strategic operational leader responsible for credentialing efficiency, scalability, and compliance.
Implement AI-powered provider onboarding workflows to reduce credentialing turnaround times.
Develop automated license, certification, and recredentialing tracking systems.
Utilize AI to analyze enrollment bottlenecks and identify process improvement opportunities.
Lead adoption of automation tools that streamline payer enrollment, document management, and compliance reporting.