symplr · 8 hours ago
Vice President, Credentialing Operations
United States
Full-time
Remote
Director/Executive
$210K/yr - $220K/yr
10+ years expsymplr is seeking a Vice President of Credentialing Operations who will oversee and manage all credentialing operations functions across the organization. This role involves developing and implementing credentialing policies and procedures, ensuring compliance with regulations, and maintaining relationships with healthcare providers.
Health CareInformation TechnologySoftware
Responsibilities
Oversee all credentialing operations and functions, ensuring timely and accurate primary source verification of credentials
Develop, implement, and optimize credentialing policies, procedures, and systems to maximize efficiency and maintain compliance
Lead and mentor a credentialing team, providing guidance and oversight to meet department goals and service level agreements
Serve as an expert and thought leader on credentialing regulations, trends, and best practices
Build and maintain positive relationships with providers and cross-functional teams
Manage credentialing budget and resources to meet organizational objectives
Ensure the accuracy and integrity of the provider database and directories
Identify opportunities for process improvement and implement changes to streamline credentialing
Qualification
Required
Bachelor's degree
10 years of experience in healthcare credentialing, with at least 5 years in a leadership role
Expert knowledge of NCQA, CMS, federal, and state credentialing regulations and standards
Proven track record of developing and managing a high-performing credentialing team
Strong project management skills with the ability to lead process improvement initiatives
Excellent communication and relationship-building skills with both internal and external stakeholders
Proficiency in credentialing software and databases
Strong process improvement background in a BPO environment
Demonstrated ability to build, monitor, and execute on customer SLA's to drive a seamless customer experience
Preferred
Master's degree
Experience with delegated credentialing models
Lean Six Sigma or other process improvement certification
Active NAMSS, CPCS, or CPMSM certification
Experience credentialing providers in multiple states
Knowledge of provider enrollment and network management
Company
symplr
Symplr is a provider of healthcare governance, risk, and compliance solutions and services.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Charlesbank Capital PartnersPamlico Capital
2022-01-05Private Equity
2021-07-12Private Equity
2018-10-23Acquired
Leadership Team
Hugo Doetsch
Chief Financial Officer
Patrick Birmingham
Executive Vice President, Credentialing Operations
Recent News
2025-11-10
SalesTech Star
2025-11-08
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