Director of Credentialing

Position Overview:

The Director of Credentialing will oversee the full verification process for radiologists, ensuring adherence to organizational and industry standards. This role is pivotal in developing and implementing policies and protocols related to physician verification.

Key Responsibilities:

Credentialing Operations:

• Manage and lead all credentialing and re-credentialing activities.
• Design and implement a high-performing credentialing program.
• Supervise daily credentialing workflows and team operations.
• Execute FPPE/OPPE processes effectively.
• Ensure full compliance with Joint Commission regulations and other relevant standards.
• Utilize and oversee credentialing software systems.
• Maintain CPCS and CPMSM certifications.
• Create efficient internal procedures for smooth operations.
• Analyze business metrics and collaborate with internal departments for data-driven improvements.
• Organize and lead meetings to share updates and address policy changes.

Leadership and Collaboration:

• Participate in clinical leadership discussions and decision-making.
• Work closely with other leaders to address challenges and advance organizational objectives.
• Facilitate interdepartmental communication and alignment.
• Contribute to process optimization initiatives and improvement projects.
• Deliver clear, consistent communication to staff and stakeholders.

Team Management:

• Recruit, onboard, and provide ongoing training for credentialing staff.
• Monitor team performance, offering coaching and development opportunities.
• Oversee remote teams, hosting virtual meetings and ensuring seamless operations.
• Develop and update standard operating procedures (SOPs) and protocols.
• Handle scheduling, staffing adjustments, and performance management, including reviews and corrective actions.
• Recommend hiring and staffing decisions.
• Act as a liaison for physicians on credentialing-related concerns.
• Take on additional duties and special projects as needed.

Qualifications and Experience:

• A Bachelor’s degree in health or business administration from an accredited institution is required.
• A Master’s degree in a health-related field is highly preferred, or an equivalent blend of education and experience.