Credentialing, Privileging & Enrollment Supervisor

AtWork Personnel Services

Sacramento, CA, USA

Published: 6/14/2022

Healthcare

Full Time

Job Description

Credentialing, Privileging & Enrollment Supervisor

Location: Sacramento, CA
Salary: $87,360 per year
Schedule: Full-Time Exempt

Position Overview

We are seeking an experienced Credentialing, Privileging & Enrollment Supervisor to lead provider credentialing and enrollment operations within a healthcare organization. This role oversees the full lifecycle of credentialing, recredentialing, privileging, and enrollment for licensed, certified, and other clinical professionals, ensuring regulatory compliance, accurate documentation, and timely processing.

The ideal candidate brings strong healthcare credentialing expertise, proven supervisory experience, and the ability to manage a team while maintaining high standards of quality, confidentiality, and compliance.

Key Responsibilities

Supervise and support the Credentialing & Enrollment team, ensuring productivity, accuracy, and timely completion of assignments.
Oversee provider credentialing, recredentialing, privileging, and enrollment processes.
Ensure compliance with California regulations, federal requirements, Medicare/Medicaid enrollment, payer credentialing, and applicable accreditation standards.
Audit credentialing applications, supporting documentation, and primary source verifications to ensure files remain current and complete.
Monitor workflows, identify process improvements, and implement policies and procedures to support departmental efficiency.
Coordinate credentialing committee activities and support provider appointment and reappointment processes.
Maintain confidential credentialing, Human Resources, and peer review information.
Collaborate with leadership, providers, and external agencies to resolve credentialing issues and maintain compliance.
Monitor quality standards and ensure credentialing activities are completed in accordance with established guidelines.

Required Qualifications

Bachelor's degree in Business Administration, Healthcare Administration, or a related field; OR five years of hospital and/or healthcare credentialing experience in lieu of a degree.
Minimum of five years of supervisory or lead experience in credentialing.
Experience supervising staff, with the ability to oversee a team of up to five employees.
Experience working within a Human Resources department.
Strong knowledge of healthcare credentialing regulations, accreditation standards, and requirements applicable to medical staff and allied health professionals.
Experience with audits involving The Joint Commission (TJC), Federal Tort Claims Act (FTCA), health plans, and/or Independent Practice Associations (IPAs).
Knowledge of Medicare and Medicaid requirements, state and federal regulations, and HIPAA.
Familiarity with medical terminology, basic anatomy and physiology, and medical staff services.
Advanced computer skills, including word processing, spreadsheets, and databases.
Excellent organizational, communication, interpersonal, and problem-solving skills.

Preferred Qualifications

Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) credential through the National Association Medical Staff Services (NAMSS).
Fluency in additional languages.

\nCompany Description

For over 30 years, clients and candidates have entrusted AtWork to provide workforce solutions nationwide. With over 80 offices nationwide, AtWork specialize in executive, professional, commercial, and government verticals. AtWork utilizes a collaborative approach where we deliver quick, high-quality results. Our customizable service portfolio focuses on direct-hire and flexible workforce solutions. Since 1986, AtWork has continued to be an award-recognized leader in the staffing industry by clients, candidates, and industry professionals.