Director of Credentialing
Location: Knoxville, TN (Remote flexibility possible) Job Type: Full-Time
Position Overview
M Force Partners is seeking an experienced Director of Credentialing to lead and oversee credentialing, privileging, and provider enrollment operations for a multi-site, multi-specialty physician group based in Knoxville, TN.
This Director of Credentialing role will manage a team of credentialing and auditing professionals while ensuring full compliance with payer, regulatory, and accreditation standards. The ideal candidate will bring strong leadership experience within multi-site healthcare organizations and a deep understanding of provider credentialing and enrollment processes.
Key Responsibilities
- Lead and manage provider credentialing, recredentialing, privileging, and payer enrollment across multiple practice locations
- Supervise, mentor, and develop a team of credentialing and auditing staff (up to 8 team members)
- Establish and maintain standardized credentialing processes across a multi-specialty physician organization
- Ensure compliance with CMS, NCQA, Joint Commission, and state regulatory requirements
- Oversee provider enrollment with commercial payers, Medicare, and Medicaid to ensure timely approvals
- Monitor credentialing files for accuracy, completeness, and regulatory compliance
- Collaborate with executive leadership, practice administrators, and revenue cycle teams to support operational goals
- Identify workflow inefficiencies and implement process improvements to enhance turnaround times and accuracy
- Manage credentialing systems and databases to maintain data integrity and reporting capabilities
- Serve as the escalation point for complex credentialing issues and payer-related challenges
- Stay current on industry regulations, payer requirements, and credentialing best practices
Required Qualifications
- 7+ years of experience in provider credentialing within a physician practice environment
- Proven leadership experience managing credentialing teams (preferably 5+ direct reports)
- Experience supporting multi-site healthcare organizations
- Experience working within multi-specialty physician groups
- Strong understanding of credentialing, privileging, and payer enrollment processes
- In-depth knowledge of CMS, NCQA, Joint Commission, and regulatory compliance standards
- Demonstrated ability to improve processes and lead operational initiatives
Preferred Qualifications
- Professional certifications such as CPMSM (Certified Professional Medical Services Management) or CPCS (Certified Provider Credentialing Specialist)
- Experience with credentialing software and provider data management systems such as CAQH or PECOS
- Understanding of the revenue cycle impact of credentialing operations
Job presented by M Force Partners
M Force Partners is a specialized recruitment partner connecting top-tier talent with leading organizations. With a deep understanding of engineering/technical, medical, professional and executive disciplines and industry demands, we deliver tailored recruitment solutions, including direct hire and contract placements, to ensure the right fit for both candidates and clients.
If this role isn't the right fit for you, we encourage you to explore our other opportunities at mforcepartners.com.
Do you know someone who may be a great match? Feel free to share this opportunity within your network
Equal Opportunity Employer
M Force Partners is an Equal Opportunity Employer. Employment decisions are based on qualifications, merit, and business needs. Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.
Director of Credentialing
Location: Knoxville, TN (Remote flexibility possible) Job Type: Full-Time
Position Overview
M Force Partners is seeking an experienced Director of Credentialing to lead and oversee credentialing, privileging, and provider enrollment operations for a multi-site, multi-specialty physician group based in Knoxville, TN.
This Director of Credentialing role will manage a team of credentialing and auditing professionals while ensuring full compliance with payer, regulatory, and accreditation standards. The ideal candidate will bring strong leadership experience within multi-site healthcare organizations and a deep understanding of provider credentialing and enrollment processes.
Key Responsibilities
- Lead and manage provider credentialing, recredentialing, privileging, and payer enrollment across multiple practice locations
- Supervise, mentor, and develop a team of credentialing and auditing staff (up to 8 team members)
- Establish and maintain standardized credentialing processes across a multi-specialty physician organization
- Ensure compliance with CMS, NCQA, Joint Commission, and state regulatory requirements
- Oversee provider enrollment with commercial payers, Medicare, and Medicaid to ensure timely approvals
- Monitor credentialing files for accuracy, completeness, and regulatory compliance
- Collaborate with executive leadership, practice administrators, and revenue cycle teams to support operational goals
- Identify workflow inefficiencies and implement process improvements to enhance turnaround times and accuracy
- Manage credentialing systems and databases to maintain data integrity and reporting capabilities
- Serve as the escalation point for complex credentialing issues and payer-related challenges
- Stay current on industry regulations, payer requirements, and credentialing best practices
Required Qualifications
- 7+ years of experience in provider credentialing within a physician practice environment
- Proven leadership experience managing credentialing teams (preferably 5+ direct reports)
- Experience supporting multi-site healthcare organizations
- Experience working within multi-specialty physician groups
- Strong understanding of credentialing, privileging, and payer enrollment processes
- In-depth knowledge of CMS, NCQA, Joint Commission, and regulatory compliance standards
- Demonstrated ability to improve processes and lead operational initiatives
Preferred Qualifications
- Professional certifications such as CPMSM (Certified Professional Medical Services Management) or CPCS (Certified Provider Credentialing Specialist)
- Experience with credentialing software and provider data management systems such as CAQH or PECOS
- Understanding of the revenue cycle impact of credentialing operations
Job presented by M Force Partners
M Force Partners is a specialized recruitment partner connecting top-tier talent with leading organizations. With a deep understanding of engineering/technical, medical, professional and executive disciplines and industry demands, we deliver tailored recruitment solutions, including direct hire and contract placements, to ensure the right fit for both candidates and clients.
If this role isn't the right fit for you, we encourage you to explore our other opportunities at mforcepartners.com.
Do you know someone who may be a great match? Feel free to share this opportunity within your network
Equal Opportunity Employer
M Force Partners is an Equal Opportunity Employer. Employment decisions are based on qualifications, merit, and business needs. Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.
