The Credentialing & Licensure Manager is responsible for the performance of the company's end-to-end credentialing operations. Duties will include management of credentialing & licensure department and personnel; establishing and managing productivity and output KPIs; establishing, assessing and improving processes to ensure team performance is maximized.
The Credentialing & Licensure Manager will lead the company's communication with key third parties/organizations such as CGFNS, Relias, US State BONs, ARRT etc. to ensure Espirita's credentialing & licensure processes & standards meet national and state requirements.
The role will be required to run & analyze reports on applications and credentialing status to assess performance, identify trends and continuously improve processes.
Responsibilities:
Oversee and manage the credentialing and re-credentialing processes, ensuring all healthcare professionals meet regulatory and company standards.
Conduct thorough primary source verification for credentials, including licenses, certifications, work history, and educational background, while maintaining accurate records in credentialing databases.
Ensure compliance with federal, state, and industry regulations and keep credentialing processes aligned with best practices.
Lead, train, and manage the credentialing team, setting performance goals, providing feedback, and ensuring high-quality standards in credentialing operations.
Develop and update credentialing policies and procedures, implementing improvements to streamline operations and enhance efficiency.
Collaborate with other departments (e.g., HR, Legal, Quality Assurance) to ensure that all credentialing requirements align with broader organizational goals and regulatory requirements.
Conduct regular audits to maintain data integrity, prepare for accreditation reviews, and generate detailed reports on credentialing status and compliance for senior management.
Qualifications:
Registered Nurse
5+ years in credentialing
Minimum of 2 years in a supervisory or management role
Experience in healthcare or medical staff services is required.
Strong knowledge of credentialing regulations, international Visa regulations, standards, and best practices required.
Excellent organizational and time-management skills, with attention to detail.
Proficiency with credentialing software and databases.
Strong analytical and problem-solving abilities.
Excellent communication and interpersonal skills for collaborating across departments.
International healthcare recruiting or credentialing experience preferred.