Associate Director, Credentialing Department

About the role

The Associate Director provides strategic and operational leadership over all aspects of provider credentialing, payer enrollment, licensing, and privileging. This role ensures compliance with federal, state, and payer regulations while supporting provider onboarding, Credentialing Committee preparation, and multi-state operations.

Responsibilities

• Lead end-to-end credentialing and payer enrollment for providers and groups across multiple states, including Medicare, Medicaid, commercial plans, and delegated enrollments.
• Oversee licensing, re-licensing, and hospital, ASC, and nursing home privileging processes.
• Collaborate closely with Organizational Leadership, Compliance, Contracting, and Revenue Cycle Management to resolve complex issues and align credentialing efforts with organizational goals.
• Ensure final preparation for Credentialing Committee review, at least twice a month.
• Manage payer enrollment expectations, timelines, and communications, ensuring timely submissions and approvals.
• Align with strategic partners to coordinate multi-state credentialing initiatives and optimize provider participation.
• Supervise, mentor, and develop the credentialing team, promoting efficiency and adherence to SLAs.
• Collaborate with internal stakeholders—including Compliance, Contracting, and Revenue Cycle Management—to resolve complex issues and optimize processes.
• Drive process improvements, policy updates, and compliance initiatives to support organizational growth and regulatory requirements.

Qualifications

• Proven experience in provider credentialing, payer enrollment, privileging, licensing, and malpractice management.
• Strong leadership, organizational, and problem-solving skills.
• Knowledge of federal and state regulations, hospital/ASC privileging, and CLIA certification requirements.
• Excellent communication and collaboration skills with internal teams, providers, and external partners.
• Minimum of one year in a healthcare setting providing medical credentialing assistance.
• PREFERRED: Strongly Preferred NAMSS certifications include Certified Provider Credentialing Specialist (CPCS), Certified Professional Medical Services Management (CPMSM), or Certified Provider Enrollment Specialist (CPES).
• EXPERIENCE: Experience in a multi-specialty medical group or large healthcare organization.
• PROCESS IMPROVEMENT: Process improvement or workflow optimization experience.

Work Experience

• Minimum of one year in a healthcare setting providing medical credentialing assistance.
• PREFERRED: Strongly Preferred NAMSS certifications include Certified Provider Credentialing Specialist (CPCS), Certified Professional Medical Services Management (CPMSM), or Certified Provider Enrollment Specialist (CPES).
• EXPERIENCE: Experience in a multi-specialty medical group or large healthcare organization.
• PROCESS IMPROVEMENT: Process improvement or workflow optimization experience.

Qualifications

• Proven experience in provider credentialing, payer enrollment, privileging, licensing, and malpractice management.
• Strong leadership, organizational, and problem-solving skills.
• Knowledge of federal and state regulations, hospital/ASC privileging, and CLIA certification requirements.
• Excellent communication and collaboration skills with internal teams, providers, and external partners.
• Minimum of one year in a healthcare setting providing medical credentialing assistance.
• PREFERRED: Strongly Preferred NAMSS certifications include Certified Provider Credentialing Specialist (CPCS), Certified Professional Medical Services Management (CPMSM), or Certified Provider Enrollment Specialist (CPES).
• EXPERIENCE: Experience in a multi-specialty medical group or large healthcare organization.
• PROCESS IMPROVEMENT: Process improvement or workflow optimization experience.

Physical Demands

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Position Type and Expected Hours to Work

• Full-Time Position
• Monday through Friday from 900 a.m. to 530 p.m. - 40 hours work week

Travel

• No travel is expected or required for this position.

Supervisor Responsibility

• As described above.

Benefits

Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.