Director of Credentialing

🕒 May 27

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American Family Care

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1982

Healthcare • Urgent Care • Family Care

American Family Care is a nationwide healthcare provider specializing in urgent care, primary care, and family care services. With a strong emphasis on accessibility and convenience, they offer a range of medical services including seasonal allergy treatment, vaccinations, physical exams, and emergency care, all designed to ensure prompt attention and a warm, caring environment for patients. American Family Care aims to deliver high-quality healthcare at lower costs compared to traditional emergency room visits, utilizing walk-in clinics and on-site labs to enhance patient experience.

📋 Description

• Provide strategic leadership for all credentialing, recredentialing, privileging, and provider enrollment activities • Build, lead, and mentor a high-performing credentialing team • Develop and implement departmental goals, SOPs, KPIs, and quality assurance measures • Oversee verification of licensure, education, training, certifications, work history, malpractice coverage, and professional references • Ensure compliance with all federal, state, and local regulatory bodies • Oversee timely and accurate submission of enrollment applications • Manage external credentialing and verification vendors • Continuously evaluate and enhance credentialing workflows

🎯 Requirements

• Bachelor’s degree in healthcare administration, business, or related field • 7 or more years of credentialing experience in a healthcare organization, MSO, medical group, ASC, or hospital • 3 or more years of leadership or management experience • Strong working knowledge of CMS, Joint Commission, NCQA, URAC, and payer credentialing and enrollment requirements • Proficiency with credentialing software systems, provider databases, and digital document management • Experience in multi-site or multi-state healthcare delivery organizations, or MSOs • Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred • Proficiency with CredentialStream/Verity preferred • Experience implementing credentialing software or leading large-scale credentialing process redesign • Exceptional attention to detail and commitment to data accuracy • Strong analytical, organizational, and project management abilities • Excellent written, verbal, and presentation development skills • Ability to lead teams through change and build scalable credentialing infrastructure • High integrity, discretion, and commitment to confidentiality • Ability to work cross-functionally and influence without formal authority • Strong relationship management and customer service orientation

🏖️ Benefits

• Comprehensive benefits package including medical, dental, vision, disability, life insurance • Matching 401(k) • Flexible work arrangements • Professional development opportunities • Paid time off