Role Summary:
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.