Director of Credentialing

USA Clinics GroupNorthbrook, IL
$90,000 - $115,000Onsite

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.

Benefits

  • Health
  • Dental
  • Vision
  • 401k & Match
  • Paid time off
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