Provider Credentialing Supervisor

Public Trust/Other Required: MBI (T2)

About the role

The Provider Credentialing Specialist serves as the operational subject matter expert (SME) supporting the design, implementation, and ongoing development of a government healthcare credentialing program. This role partners with government stakeholders, business teams, and technical resources to translate operational requirements into scalable credentialing workflows while ensuring compliance with CMS, NCQA, organizational policies, and regulatory requirements.

Responsibilities

• Serve as the primary operational contact for government stakeholders regarding credentialing operations.
• Support implementation activities for new credentialing processes and system enhancements.
• Document business requirements and translate operational workflows for technical teams.
• Perform initial credentialing and recredentialing activities.
• Complete Primary Source Verification (PSV) for all required credentialing elements.
• Review provider applications for completeness and compliance.
• Prepare credentialing files for committee review.
• Ensure credentialing files meet organizational, CMS, and NCQA standards.
• Develop and maintain standard operating procedures (SOPs).
• Participate in workflow design and process improvement initiatives.
• Assist with User Acceptance Testing (UAT) during system implementations.
• Identify workflow gaps and recommend operational improvements.
• Collaborate with cross-functional teams including IT, compliance, operations, and government stakeholders.
• Maintain credentialing documentation and audit readiness.
• Monitor credentialing timelines and ensure compliance with established turnaround times.

Requirements

• 3+ years of related experience
• Experience with Documentation Review, Document Reporting, Operational Requirements, Standard Operating Procedure (SOP)
• US Citizenship not required

Pay

The likely salary range for this position is $53,310 - $61,525.

Schedule

• Scheduled Weekly Hours: 40
• Travel Required: Less than 10%
• Telecommuting Options: Remote

Benefits

Our benefits package for all US-based employees includes:

• A variety of medical plan options, some with Health Savings Accounts
• Dental plan options
• A vision plan
• A 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match
• Paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave
• Short and long-term disability benefits
• Life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance