Director of Credentialing and Compliance - Remote

Overview

The Director of Credentialing and Compliance at Spring Health will oversee the credentialing function, ensuring compliance with healthcare standards while leading a team and implementing new tools.

In Short

• Manage credentialing and recredentialing of practitioners.
• Build and oversee Payer enrollment processes.
• Ensure quality in credentialing operations.
• Work cross-functionally with various teams.
• Act as a Subject Matter Expert for credentialing.
• Establish performance goals for the Credentialing department.
• Implement new credentialing tools to enhance efficiency.
• Conduct regular audits for data accuracy.
• Collaborate with Revenue Cycle Management for claims processing.
• Provide leadership and development opportunities for the team.

Requirements

• 10+ years in healthcare credentialing and compliance.
• Proven leadership experience with large teams.
• Deep knowledge of NCQA accreditation standards.
• Strong process improvement skills.
• Experience in payer relations and audits.
• Exceptional analytical and problem-solving skills.
• Strong collaboration and stakeholder management skills.
• Excellent communication skills.
• Commitment to high-performance culture.
• Preferred certifications in credentialing management.

Benefits

• Health, Dental, Vision benefits from day one.
• 401(k) match for retirement planning.
• No cost visits to Spring Health network providers.
• Competitive paid time off policies.
• Parental leave after 6 months tenure.
• Access to weight management and fertility care support.
• Access to fitness and wellness options.
• Professional Development Reimbursement.
• Donation matching for charitable causes.
• More benefits available upon hiring.