Credentialing Director

5 days ago


hyderabad, India Insight Global Full time

Healthcare Credentialing Operations Director Must HavesBachelor’s degree in healthcare administration, business, or a related field (Master’s degree preferred) or equivalent experienceMinimum of 7 years of experience in payer enrollment, licensing, and credentialing within the healthcare sector.Proven leadership experience in managing offshore teams and overseeing operational departments.Strong understanding of healthcare regulations, payer requirements, and credentialing processes.Excellent communication, problem-solving, and team-building skills.Ability to manage multiple projects and priorities in a fast-paced environmentPlusses:Master’s Degree in healthcare administration, business, or a related fieldPrior Start-Up experience Summary: The Operations Director will oversee and lead a team responsible for payer enrollment, state licensing, and credentialing functions. This leadership role is critical to ensuring smooth operations, compliance with regulatory standards, and efficient management of all processes related to healthcare provider enrollments, state licensing, and credentialing. The ideal candidate will have strong operational and team management skills, a deep understanding of healthcare regulations, and experience in building and leading offshore teams.Key Responsibilities:● Strategic Leadership: ○ Develop and implement the operational strategy for payer enrollment, state licensing, and credentialing processes in collaboration with onshore leadership. ○ Oversee daily operations, ensuring all processes are streamlined, efficient, and meet key performance indicators (KPIs). ○ Maintain up-to-date knowledge of payer requirements, healthcare regulations, and compliance standards.● Team Management: ○ Recruit, train, and manage an offshore team of professionals responsible for payer enrollment, licensing, and credentialing. ○ Ensure the team has the necessary tools and resources to perform their duties effectively. ○ Foster a culture of continuous improvement, teamwork, and accountability within the team.● Compliance & Reporting: ○ Ensure adherence to all applicable laws, regulations, and standards related to payer enrollment, licensing, and credentialing. ○ Prepare and present reports to senior management on department performance, including metrics, challenges, and improvements.● Stakeholder Management: ○ Serve as the primary point of contact for onshore leadership



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