Supervisor, Credentialing

Conifer Health Solutions•Dallas, TX

5d•Hybrid

About The Position

The Supervisor, Credentialing Operations, Training & Provider Readiness leads the GBC Credentialing team and serves as the subject matter expert (SME), trainer, and day-to-day oversight lead for credentialing and market operations. This role is accountable for building team knowledge, driving urgency, and protecting the accuracy and timeliness of credentialing work so providers are onboarded, enrolled, and billing-ready without delaying their ability to generate revenue. This role owns training, onboarding, continuous education, and staff development for the department. Using audit findings, operational trends, and performance data, it proactively identifies opportunities to improve competency, reduce errors, and increase consistency. The Supervisor also directly manages the organization's Priority Provider Readiness Program as a hands-on individual contributor for leadership-approved priority providers, ensuring designated providers move through the credentialing and enrollment pipeline and are fully billing-ready on Day One whenever payer and operational requirements allow. This is a hybrid leadership role. The supervisor serves as an individual contributor for leadership-approved Priority Providers, directly managing those high-risk readiness plans through completion. For broader team operations, success is measured by how effectively the supervisor leads, trains, monitors, and improves team performance, including accuracy, consistency, turnaround, and reduced critical misses. The supervisor redirects routine work to the correct owners, removes barriers, and oversees quality rather than personally completing all team-assigned work.

Requirements

Advanced knowledge of provider credentialing and enrollment operations and payer onboarding requirements
Strong organization, prioritization, project management, and follow-through on time-sensitive work
Ability to analyze data and identify operational trends
Strong leadership, coaching, and employee development skills
Excellent written and verbal communication and stakeholder management with leaders and cross-functional partners
Proficiency in Microsoft Office applications
Three (3) or more years of credentialing, provider enrollment, or healthcare operations experience
Demonstrated experience overseeing credentialing and market operations, including onboards, payer packet auditing, non-delegated submissions, expirable management, and priority provider readiness work
Working knowledge of delegated, non-delegated, and government enrollment pathways
Experience with credentialing and provider systems (for example ECHO, Athena, payer trackers) and reporting platforms
Proven ability to train, coach, and document processes clearly
Experience using quality audits and operational performance metrics to drive improvement

Nice To Haves

Bachelor's degree in Healthcare Administration, Business Administration, or a related field preferred
Equivalent experience may be considered

Responsibilities

Direct supervision of the GBC Credentialing team and day-to-day task oversight of the offshore market team
Training and onboarding for all team members: FTE, offshore, and contractor
Quality oversight, audit follow-through, and corrective action
Escalation routing, tracking, and closure for operational issues and leadership requests
Ownership of training materials, SOPs, job aids, checklists, and the knowledge repository
Hands-on ownership of the Priority Provider Readiness Program for leadership-approved priority providers
Oversight of provider onboards and ancillary PIF management, with direct hands-on involvement limited to priority providers
Payer packet auditing and PSV-ready packet standards
Non-delegated submissions and follow-up
Expirable management
Oversight of ECHO builds, payer tracker maintenance, and Athena management standards
Oversight and escalation support for claim and issue resolution tied to credentialing and market work
Leadership and Team Management: Directly supervise all GBC Credentialing team members and set performance expectations aligned to organizational goals
Conduct regular coaching sessions, one-on-ones, and performance evaluations
Develop employee growth and succession planning strategies
Foster a culture of accountability, collaboration, customer service, and continuous improvement
Monitor productivity and quality performance metrics and manage workload distribution
Subject Matter Expertise: Serve as the go-to SME for all credentialing and market functions and explain the “why” behind each step, not just the clicks
Understand and teach how market work depends on and feeds the PSV, Delegation, and Government teams
Teach the differences between delegated, non-delegated, and government enrollment pathways, including where handoffs occur
Complete the groundwork before drawing conclusions: review source materials, trace root cause, validate details, and assess full impact
Validate that a process is current and correct before teaching it; confirm through the appropriate source rather than memory or habit
Training and Staff Development: Serve as the departmental owner of credentialing training and education
Run structured onboarding for every new FTE, offshore, and contractor team member
Create and maintain SOPs, job aids, audit checklists, competency assessments, and a centralized knowledge repository
Host recurring re-trainings and “back to basics” refreshers targeted at identified gaps
Coordinate cross-training initiatives to improve operational flexibility and coverage
Hold weekly check-ins with trainees and offshore team members and track their progress
Partner with the Credentialing Auditor and managers to identify individual and team weak spots using audit findings and quality trends, then report findings and recommended training actions to leadership
Measure training effectiveness through accuracy, consistency, repeat-error reduction, and applied behavior; fold results into specialist reports shared with managers
Ensure training aligns with organizational policies, payer requirements, and regulatory standards
Quality Assurance, Accountability, and Process Improvement: Partner with the Credentialing Auditor to review audit findings and quality trends; analyze recurring errors and identify root causes
Develop, implement, and complete corrective action plans
Audit team output for accuracy and provide direct, specific, real-time corrective feedback
Partner with the manager to determine appropriate accountability, coaching, or follow-up
Own process integrity and standardize “what good looks like” at each handoff point
Implement process improvements that increase accuracy and efficiency, and maintain readiness for internal and external audits
Provider Readiness Program Management: Serve as the hands-on owner for leadership-approved priority providers
Develop and personally maintain readiness plans, milestone tracking, risks, and escalations for assigned priority providers
Coordinate activities across: Credentialing and Provider Enrollment, Contracting and Network Development, Revenue Cycle, Practice Operations and Provider Onboarding
Escalate barriers that threaten provider readiness timelines
Provide leadership visibility through readiness reporting and dashboards
Drive priority providers toward credentialed, enrolled, and billing-ready status by their first day whenever payer and operational requirements allow
Sense of Urgency and Escalation Ownership: Treat onboarding timelines, PEA/PSA execution windows, roster deadlines, and leadership requests as time-sensitive priorities
Acknowledge leadership requests promptly, clarify priority, and confirm next steps
Prioritize supervisory follow-up based on risk, deadline sensitivity, and downstream impact to providers, markets, and partner teams; directly work priority provider barriers when assigned
Monitor aging work, missing packet items, and open follow-ups, and reinforce urgency across the team
Reinforce escalation pathways, route issues to the correct owner, and follow up to confirm resolution
Investigate issues fully before presenting to leadership: gather context, validate facts, identify root cause and impact, and bring a recommended next step
Identify trends and barriers early and partner with the appropriate owner to mitigate risk before escalation
Communicate professionally with market leaders, peers, and cross-functional partners, and provide proactive updates on urgent items until completion
Operational Oversight and Reporting: Monitor credentialing pipeline performance and readiness metrics
Develop operational reports and dashboards, and ensure adherence to established SLAs
Provide regular reporting to managers and leadership on open issues, training progress, team knowledge levels, recurring trends, quality concerns, and recommended next steps
Provide supervisory, training, and workflow insights that support a repeatable, scalable onboarding path for a growing offshore, contractor, and FTE workforce
Share quality trends and training outcomes to help define KPIs and quality standards as the team expands
Maintain a forward-looking training roadmap and support strategic initiatives and organizational growth
Compliance and Regulatory Oversight: Ensure compliance with NCQA standards, delegated credentialing agreements, CMS regulations, organizational policies, and payer requirements
Maintain current knowledge of industry regulations and best practices
Support accreditation reviews and audit activities