Director - Credentialing & Enrollment Services

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Director - Credentialing & Enrollment Services in the United States.

The Director of Credentialing & Enrollment Services provides strategic and operational leadership for provider credentialing, re-credentialing, and payer enrollment across a diverse portfolio of healthcare clients. This role focuses on building scalable processes, ensuring regulatory compliance, driving client satisfaction, and leading a high-performing, distributed team. The position requires strong cross-functional collaboration with clients, operational teams, and executive leadership to deliver timely and accurate credentialing and enrollment services. The director will oversee operational performance, implement process improvements, and maintain high-quality outcomes across multiple locations and time zones. This is an ideal opportunity for an experienced leader who thrives in a dynamic, regulatory-driven environment and is passionate about operational excellence, team development, and client success.

• Lead and oversee end-to-end credentialing, re-credentialing, and payer enrollment operations for providers, ensuring compliance with NCQA, URAC, CMS, Joint Commission, and state-specific regulations.
• Develop and execute the strategic vision for credentialing and enrollment services, aligning operational processes with client expectations and organizational goals.
• Manage and develop a geographically distributed team of credentialing specialists, enrollment coordinators, and team leads, ensuring consistent quality standards and operational continuity.
• Serve as the primary escalation point for client concerns, maintaining strong relationships with key stakeholders, including practice managers, revenue cycle leaders, and C-suite executives.
• Drive process improvements and leverage technology, analytics, and automation to increase efficiency, scalability, and accuracy across all service lines.
• Maintain up-to-date knowledge of regulatory requirements, payer enrollment guidelines, and delegated credentialing agreements to mitigate compliance risks.
• Monitor performance metrics, client satisfaction, and turnaround times to ensure high-quality, timely service delivery.

Requirements

• 5–7+ years of progressive experience in provider credentialing and payer enrollment, including management-level responsibilities.
• Demonstrated success managing credentialing/enrollment operations in multi-client or outsourced environments.
• Proven ability to lead, develop, and retain teams of 10+ credentialing and enrollment professionals across multiple regions.
• Strong knowledge of NCQA credentialing standards, CMS enrollment regulations, CAQH/PECOS/NPPES systems, and state-specific credentialing requirements.
• Experience managing client relationships, resolving escalations, and ensuring service quality and compliance.
• Familiarity with Lean, Six Sigma, or other process improvement methodologies.
• Strong operational, analytical, and data-driven decision-making skills.
• Bachelor’s degree in Healthcare Administration, Business Administration, or a related field required; Master’s degree or relevant certifications (CPCS, CPMSM) preferred.
• Flexibility to travel 0–50% as needed and work in a remote or hybrid environment.

Benefits

• Competitive salary and performance-based incentives.
• Flexible remote or hybrid work arrangements with support for home office setup.
• Comprehensive health, dental, and vision coverage.
• Retirement plan options with employer contributions.
• Paid time off, parental leave, and wellness programs.
• Professional development opportunities, mentorship, and leadership training.
• Collaborative, inclusive, and high-performing work culture.