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Director Of Credentialing Jobs (NOW HIRING)

ProviDRs Care

Credentialing Lead

Wichita, KS · On-site

Director of Provider Relations and Credentialing Classification: Full-Time Department: Provider Network Operations / Credentialing & Enrollment Requirements Education * High school diploma or GED ...

ProviDRs Care

Credentialing Lead

Wichita, KS

$40K - $70K/yr

Director of Provider Relations and Credentialing Classification: Full-Time Department: Provider Network Operations / Credentialing & Enrollment RequirementsEducation * High school diploma or GED ...

Anders

Credentialing Specialist

Saint Louis, MO · On-site +1

$48K - $62K/yr

This individual will have a direct impact on our firm's mission of serving as a catalyst for those striving to achieve their highest potential. The Credentialing Specialist for the Credentials ...

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How much do director of credentialing jobs pay per year?

As of Jul 16, 2026, the average yearly pay for director of credentialing in the United States is $85,031.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,000.00 and $94,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Director of Credentialing, and why are they important?

To thrive as a Director of Credentialing, you need in-depth knowledge of credentialing standards, healthcare regulations, and experience with provider enrollment, often supported by a degree in healthcare administration or a related field. Familiarity with credentialing software systems (such as CAQH or Verity), compliance management tools, and industry certifications like CPCS or CPMSM is typically required. Strong leadership, analytical thinking, and effective communication are crucial soft skills for managing teams and collaborating with providers and regulatory bodies. These competencies ensure the organization maintains regulatory compliance, reduces risk, and delivers efficient, high-quality credentialing services.

What does a Director of Credentialing do?

A Director of Credentialing oversees the process of verifying and maintaining the credentials of healthcare providers within an organization. This role ensures that all physicians, nurses, and allied health professionals meet the necessary licensing, certification, and regulatory requirements. The director manages credentialing staff, develops and updates policies, and coordinates with regulatory bodies to maintain compliance. They play a critical role in ensuring patient safety and organizational integrity by confirming provider qualifications.

What is the difference between Director Of Credentialing vs Credentialing Specialist?

AspectDirector Of CredentialingCredentialing Specialist
ResponsibilitiesOversees credentialing processes, manages teams, develops policiesPerforms credentialing tasks, verifies credentials, maintains records
Required CredentialsBachelor's degree, experience in credentialing, leadership skillsHigh school diploma or associate's, certification preferred, detail-oriented
Work EnvironmentHealthcare organizations, hospitals, clinicsMedical offices, healthcare facilities, credentialing departments

The main difference is that the Director Of Credentialing manages the entire credentialing department and develops policies, while the Credentialing Specialist handles day-to-day credential verification tasks. The director role involves leadership and strategic planning, whereas the specialist focuses on operational tasks.

What are the primary challenges faced by a Director of Credentialing in maintaining compliance across multiple healthcare facilities?

A Director of Credentialing often manages credentialing processes for various providers and facilities, which can present challenges such as staying up to date with differing regulatory requirements, coordinating with multiple state and federal agencies, and ensuring all documentation is consistently accurate and complete. Effective communication with providers and internal teams is essential to prevent delays and mitigate risks of non-compliance. Additionally, adapting to frequent changes in accreditation standards and payer requirements requires a proactive approach and ongoing professional development.
More about Director Of Credentialing jobs
What cities are hiring for Director Of Credentialing jobs? Cities with the most Director Of Credentialing job openings:
What states have the most Director Of Credentialing jobs? States with the most job openings for Director Of Credentialing jobs include:
What job categories do people searching Director Of Credentialing jobs look for? The top searched job categories for Director Of Credentialing jobs are:
Director Of Credentialing jobs near you
Infographic showing various Director Of Credentialing job openings in the United States as of July 2026, with employment types broken down into 92% Full Time, and 8% Nights. Highlights an 83% In-person, and 17% Remote job distribution, with an average salary of $85,031 per year, or $40.9 per hour.
Credentialing Lead

Credentialing Lead

ProviDRs Care

Wichita, KS • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 16 days ago

Job description


Credentialing Coordinator
Position Summary
The Credentialing Lead is responsible for overseeing and executing complex provider credentialing activities across multiple states and payer networks. This role serves as the subject matter expert for escalated credentialing issues, ensures regulatory and accreditation compliance, manages provider credential expirations, and drives operational excellence within the credentialing function. The Credentialing Lead owns the credentialing work queue, prioritizes high-risk and time-sensitive cases, and partners closely with providers, payers, licensing boards, and internal stakeholders to ensure timely enrollment and ongoing compliance.
Key Responsibilities
Credentialing Operations
  • Manageand maintain ownership of the credentialing and recredentialing workqueue, ensuring timely processing and resolution of cases.
  • Handlecomplex credentialing scenarios, including multi-state licensure, payerenrollment challenges, provider relocations, and high-priority onboardingcases.
  • Coordinateand submit credentialing applications to commercial, government, andmanaged care payers.
  • Monitorcredentialing status and proactively address delays, deficiencies, orbarriers to enrollment.

Escalation Management
  • Serveas the primary escalation point for credentialing-related issues.
  • Investigateand resolve complex credentialing and enrollment problems with payers,providers, and regulatory agencies.
  • Developcorrective action plans and drive issues through resolution whilemaintaining stakeholder communication.

Expiration & Compliance Management
  • Overseetracking and management of provider licenses, certifications,registrations, malpractice insurance, and other credentialingrequirements.
  • Ensuretimely renewals and prevent lapses that could impact provider eligibilityor reimbursement.
  • Maintainaccurate credentialing records and documentation in credentialing systemsand databases.

Accreditation & Quality Oversight
  • Maintaincredentialing processes in accordance with accreditation standards.
  • Supportaudits, accreditation reviews, and internal quality assurance initiatives.
  • Ensurecredentialing policies, procedures, and documentation remain compliantwith regulatory and accreditation requirements.
  • Identifyprocess improvement opportunities and implement best practices tostrengthen compliance and operational efficiency.

Leadership & Collaboration
  • Provideguidance and mentorship to credentialing specialists and team members.
  • Establishand monitor credentialing performance metrics, service levels, and qualitystandards.
  • Collaboratewith Provider Operations, Compliance, Revenue Cycle, Clinical Leadership,and external partners to support organizational goals.
  • Assistin developing workflows, training materials, and standard operatingprocedures.

Qualifications
Required
  • 3+years of provider credentialing experience, including payer enrollment andrecredentialing.
  • Demonstratedexperience managing complex credentialing cases and multi-state providercredentials.
  • Strongunderstanding of credentialing regulations, payer requirements, andprovider enrollment processes.
  • Experienceworking with credentialing software, CAQH, NPPES, PECOS, and statelicensing boards.
  • Knowledgeof accreditation standards such as NCQA, URAC, or Joint Commission.
  • Excellentorganizational, problem-solving, and communication skills.
  • Abilityto manage multiple priorities in a fast-paced environment.

Preferred
  • CertifiedProvider Credentialing Specialist (CPCS) certification.
  • Experienceleading credentialing operations or serving as a team lead.
  • Experiencesupporting multi-state healthcare organizations.
  • Advancedreporting and process improvement experience.

Success Measures
  • Credentialingand enrollment turnaround times meet or exceed organizational goals.
  • Providercredential expirations are proactively managed with minimal to no lapses.
  • Escalatedcredentialing issues are resolved efficiently and effectively.
  • Accreditationand audit requirements are consistently met.
  • Credentialingqueue remains current and within established service level agreements.
  • Highlevels of provider and internal stakeholder satisfaction.

Reports To: Director of Provider Relations and Credentialing
Classification: Full-Time
Department: Provider Network Operations / Credentialing & Enrollment
Requirements
Education
  • High school diploma or GED required
  • Associate's or Bachelor's degree in Healthcare Administration, Business Administration, or related field preferred
Experience
  • 3+ years of provider credentialing or medical staff services experience preferred
  • Experience with payer enrollment and provider credentialing processes
  • Knowledge of commercial, Medicare, and Medicaid enrollment requirements
  • Experience working in a healthcare organization, provider network, or health plan preferred
Required Knowledge
  • Provider credentialing and re-credentialing processes
  • Primary Source Verification (PSV)
  • CAQH ProView maintenance
  • NPI and PECOS enrollment
  • Medicare, Medicaid, and commercial payer enrollment
  • NCQA, CMS, Joint Commission, and state regulatory requirements
  • Provider file maintenance and document management
  • Medical terminology and healthcare operations
Technical Skills
  • Microsoft Office (Excel, Word, Outlook)
  • Credentialing software
  • Electronic document management systems
  • Database management and accurate data entry
  • Internet research and state licensing board websites
Core Competencies
  • Exceptional attention to detail
  • Strong organizational skills
  • Time management and prioritization
  • Excellent written and verbal communication
  • Customer service orientation
  • Problem-solving and critical thinking
  • Ability to manage multiple deadlines
  • Ability to work independently and collaboratively
  • Confidentiality and professionalism

Benefits
Health Insurance
Dental Insurance
Vision Insurance
Paid Time Off (PTO)
Employee Assistance Program (EAP)
401(k) with Employer Contribution
Health Savings Account (HSA)
Flexible Savings Account (FSA)
Referral Program
Life Insurance
Discounted Gym Membership

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