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Director, Provider Credentialing

DirectorDirectorOtherRemoteTeam 316Since 2016Company Site

Location

United States

Posted

103 days ago

Salary

0

No structured requirement data.

Job Description

Director, Provider Credentialing

Synapse Health

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Synapse Health is seeking a Director, Provider Credentialing to lead and mature our provider credentialing function as we expand nationally. This role will oversee the end-to-end credentialing program for Synapse and our downstream supplier network while establishing strong governance over provider credentialing processes, data integrity, and regulatory compliance. This Director will bring the expertise, systems thinking, and cross-functional leadership required to design and manage a credentialing program that is scalable, defensible, and operationally efficient. Reporting into the Solutions & Implementation organization, this role will lead credentialing strategy, modernize workflows and systems, and partner closely with Compliance, Network Operations, Technology, and Clinical teams to ensure credentialing standards support both regulatory requirements and operational excellence. What You Will Do - Lead the end-to-end provider credentialing program for Synapse Health and its downstream supplier network. - Design and implement national credentialing standards and processes to support Synapse’s expanding provider network. - Establish and maintain scalable credentialing policies, workflows, and controls that meet health plan, regulatory, and accreditation requirements. - Serve as the organizational leader for credentialing operations, ensuring processes are defensible, consistent, and audit-ready. - Oversee credentialing workflows including verification, monitoring, and documentation related to licensure, registration, and credentialing requirements. - Partner with Compliance and Legal teams to ensure credentialing programs align with regulatory and accreditation standards. - Lead implementation and optimization of credentialing technology platforms and workflow automation tools to streamline operations and improve scalability. - Develop and maintain reporting and operational dashboards to monitor credentialing performance, compliance, and operational risk. - Serve as the primary internal subject matter expert and external point of contact for credentialing inquiries from health plans, auditors, and regulatory bodies. - Partner cross-functionally with Supplier Operations, Clinical Operations, Technology, and Compliance teams to ensure credentialing data and processes support operational workflows. - Manage and develop the credentialing team, driving operational efficiency and reducing reliance on temporary staffing through improved processes and systems. - Continuously evaluate opportunities to improve credentialing efficiency, data accuracy, and regulatory compliance. Qualifications - Bachelor’s degree in Healthcare Administration, Business Administration, or a related field (Master’s degree preferred). - 10+ years of experience in provider credentialing, network operations, healthcare operations, or related healthcare administration functions. - Experience managing credentialing programs in managed care, provider networks, DMEPOS, or healthcare services environments. - Demonstrated experience leading operational teams and building scalable processes. - Strong understanding of credentialing requirements including provider licensure, accreditation, and regulatory compliance standards. - Experience working with credentialing systems, workflow tools, and operational technology platforms. - Ability to translate complex regulatory and operational requirements into scalable processes and policies. - Excellent communication and stakeholder management skills with the ability to work across operational, clinical, and compliance teams. - Strong analytical and organizational skills with attention to detail and process integrity. Requirements - Strategic Thinking: Ability to design scalable credentialing frameworks that support organizational growth while maintaining regulatory compliance. - Operational Leadership: Demonstrates the ability to build and lead high-performing operational teams and processes. - Cross-Functional Collaboration: Works effectively across departments to ensure credentialing processes align with operational and regulatory requirements. - Decision Making: Evaluates complex regulatory and operational considerations to drive sound, well-informed decisions. Compensation The base salary range for this position is $147,200 – $184,000 annually. This range reflects the anticipated compensation at the time of posting. Final compensation will be based on factors such as relevant experience, demonstrated skills, internal equity, and prevailing market conditions. Compensation discussions are encouraged throughout the hiring process. Benefits - Professional growth opportunities with compelling career paths. - Healthy work-life balance supported by flexible paid time off (PTO). - Comprehensive benefits package, including medical, dental, vision, STD & LTD insurance for full-time team members. - 401(k) savings plan with employer matching contributions.

Job Requirements

  • Bachelor’s degree in Healthcare Administration, Business Administration, or a related field (Master’s degree preferred).
  • 10+ years of experience in provider credentialing, network operations, healthcare operations, or related healthcare administration functions.
  • Experience managing credentialing programs in managed care, provider networks, DMEPOS, or healthcare services environments.
  • Demonstrated experience leading operational teams and building scalable processes.
  • Strong understanding of credentialing requirements including provider licensure, accreditation, and regulatory compliance standards.
  • Experience working with credentialing systems, workflow tools, and operational technology platforms.
  • Ability to translate complex regulatory and operational requirements into scalable processes and policies.
  • Excellent communication and stakeholder management skills with the ability to work across operational, clinical, and compliance teams.
  • Strong analytical and organizational skills with attention to detail and process integrity.
  • Strategic Thinking: Ability to design scalable credentialing frameworks that support organizational growth while maintaining regulatory compliance.
  • Operational Leadership: Demonstrates the ability to build and lead high-performing operational teams and processes.
  • Cross-Functional Collaboration: Works effectively across departments to ensure credentialing processes align with operational and regulatory requirements.
  • Decision Making: Evaluates complex regulatory and operational considerations to drive sound, well-informed decisions.
  • Compensation
  • The base salary range for this position is $147,200 – $184,000 annually. This range reflects the anticipated compensation at the time of posting. Final compensation will be based on factors such as relevant experience, demonstrated skills, internal equity, and prevailing market conditions. Compensation discussions are encouraged throughout the hiring process.

Benefits

  • Professional growth opportunities with compelling career paths.
  • Healthy work-life balance supported by flexible paid time off (PTO).
  • Comprehensive benefits package, including medical, dental, vision, STD & LTD insurance for full-time team members.
  • 401(k) savings plan with employer matching contributions.

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