Associate Director, Credentialing Department

Overview

As the Associate Director, you will provide 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.

• 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, ambulatory surgery center (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 once 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.
• Must hold a valid Notary Public commission in the State of New York.

• 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.

• Bachelor’s Degree in a Health-Related Discipline (Public Health, Healthcare Administration, Health Service, Psychology or Sociology) – Highly Preferred
• High School Diploma Required
• Minimum of six months in a healthcare setting providing clerical support or medical credentialing assistance

• NAMSS certifications (CPCS, CPMSM, CPES) strongly preferred
• Experience in a multi-specialty medical group or large healthcare organization
• Process improvement or workflow optimization experience

• Strong interpersonal and communication skills; ability to work with diverse teams, managers, and vendors
• Proficiency with MS Office (Outlook, Word, Excel, PowerPoint, Access)
• Excellent organizational and time-management skills
• Ability to analyze, interpret, and report on research findings
• Working knowledge of clinical operations and procedures
• Database management skills including querying, reporting, and document generation
• Ability to exercise independent judgment and manage confidential information

The physical demands and work environment described are representative of those required to perform the essential functions of this job.

Full-Time, Monday through Friday, 9:00 a.m. to 5:30 p.m. (40 hours per week).

No travel is expected or required for this position.

As described above.

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.