Director of Credentialing
Director of Credentialing
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Salary Not Disclosed
1 Vacancy
Job Description
Overview
The Director of Credentialing is responsible for the overall leadership management and strategic direction of the credentialing and privileging process across the organization. This role ensures that all healthcare providers practicing within correctional facilities (prisons and jails) meet applicable state federal and contractual requirements as well as internal standards of excellence. The Director will oversee provider credentialing recredentialing privileging and compliance monitoring to ensure uninterrupted access to high-quality healthcare services.
Responsibilities
The Director of Credentialing is responsible for:
- Leadership & Oversight
- Direct and manage the credentialing department including staff supervision training and performance management.
- Develop and implement credentialing policies procedures and workflows in alignment with NCCHC state medical boards and contractual requirements.
- Credentialing & Privileging
- Oversee initial credentialing recredentialing and privileging for physicians nurse practitioners physician assistants pharmacists behavioral health providers and other licensed staff.
- Ensure timely and accurate processing of provider applications verifications and committee approvals to support recruitment and onboarding.
- Partner with Medical Directors and corporate leadership to maintain up-to-date provider rosters and ensure compliance with supervisory and collaborative agreement requirements across states.
- Regulatory & Contractual Compliance
- Monitor compliance with federal and state regulations governing provider credentialing in correctional settings.
- Maintain readiness for audits by government agencies accrediting bodies and correctional system partners.
- Ensure adherence to payer credentialing and managed care requirements when applicable.
- Collaboration & Communication
- Serve as the primary liaison between Operations HR Recruiting and Clinical leadership regarding credentialing status and timelines.
- Provide clear reporting on credentialing metrics risk areas and provider readiness to support staffing in facilities.
- Support site-level Medical Directors in understanding credentialing requirements and managing collaborative agreements.
- Quality & Process Improvement
- Evaluate credentialing processes for efficiency compliance and best practices; lead continuous improvement initiatives.
- Leverage credentialing software systems to track applications expirables and reporting requirements.
- Implement consistent credentialing standards across multiple states and facilities.
Qualifications
Experience/ Requirements/ Qualifications/ Skills:
- Bachelors degree in Healthcare Administration Nursing or related field required; Masters degree preferred.
- Minimum of 710 years of experience in credentialing with at least 35 years in a leadership role.
- CPCS or CPMSM certification preferred.
- Strong knowledge of NCCHC as well as state-specific licensing requirements.
- Experience with correctional healthcare strongly preferred.
- Excellent organizational communication and leadership skills.
- Ability to work collaboratively with cross-functional teams and manage multiple priorities in a fast-paced environment.
Why Join NaphCare
NaphCare Benefits for Full-Time Employees Include:
- Health dental & vision insurance that starts day one!
- Prescriptions free of charge through our health plan beginning day one
- Lowest Cost Benefits!
- Employee Assistance Program (EAP) services
- 401K and Roth with company contribution that starts day one!
- Tuition Assistance
- Referral bonuses
- Term life insurance at no cost to the employee
- Generous paid time off & paid holidays
- Free continuing education and CMEs
Want a better idea of what its like to work in a jailSee what our MHPs do:
NaphCare - Life as a Mental Health Professional - YouTube
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Required Experience:
Director
Employment Type
Full-Time
