Credentialing Operations Manager

Posted Tuesday, February 10, 2026 at 6:00 AM

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.

We’re
proud to be recognized—again! For the fourth year in a row, we’ve been certified by Great Place to Work® , and for the third consecutive year, we’ve earned a spot on Fortune's Best Workplaces in Health Care™ list . These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people thrive.

Watch this short video for a brief introduction to Paradigm.

Paradigm Specialty Networks is seeking an experienced Credentialing Operations Manager to lead and continuously improve our clinician and facility credentialing and recredentialing programs. This full-time, exempt role is responsible for ensuring compliance with regulatory and accreditation standards while driving efficient, accurate, and timely credentialing operations across the organization.

Reporting to the VP of Strategic Initiatives & Execution, the Credentialing Operations Manager partners closely with internal teams, providers, facilities, and delegated entities to support audit readiness, policy development, and process improvement initiatives. This position plays a critical role in maintaining high-quality standards and supporting enterprise-wide operational excellence.

This is a full-time hybrid position
, with an expectation to report to the Tampa office as needed.

• Oversee and manage the initial credentialing process for all clinicians (physicians, advanced practice providers, allied health professionals) and healthcare facilities.
• Ensure all applications and supporting documentation are collected, verified, and maintained according to organizational policies and regulatory requirements.
• Coordinate and communicate with providers, facilities, and internal teams to resolve discrepancies and expedite credentialing timelines.

• Lead and manage periodic recredentialing of clinicians and facilities in compliance with organizational, state, and federal guidelines.
• Monitor upcoming recredentialing deadlines and proactively communicate with providers and facilities to ensure timely completion.
• Analyze data and develop process improvements to streamline recredentialing activities and enhance compliance.

• Develop and implement audit tools and protocols to assess delegated entities' compliance with credentialing standards.
• Conduct regular delegation audits, document findings, and report results to leadership and relevant stakeholders.
• Provide guidance and corrective action plans for delegated entities not meeting performance or compliance expectations.

• Maintain and update credentialing and recredentialing policies to reflect current regulations and best practices.
• Train and support credentialing staff on policies, procedures, and regulatory changes.

• Ensure all credentialing activities align with NCQA, URAC, The Joint Commission, and other relevant accreditation standards.
• Prepare for and participate in internal and external audits and surveys.

• Act as a primary point of contact for credentialing inquiries from providers, facilities, internal departments, and regulatory agencies.
• Provide regular updates and reports on credentialing status, compliance metrics, and audit outcomes to senior leaders.
• Leadership and team management
• Process improvement and project management
• Regulatory compliance and audit readiness
• Problem-solving and critical thinking
• Interpersonal and stakeholder relationship skills
• Responsible for complying with Paradigm Information Security requirements and…