Credentialing Supervisor
Description
Job Purpose: As the Credentialing Supervisor, you'll lead our credentialing team to ensure all providers are verified, compliant, and ready to deliver exceptional care. In this vital role, you’ll oversee credentialing, recredentialing, and privileging processes to meet internal standards and external requirements. You’ll serve as the key liaison between providers, payers, and internal departments, while supporting team development, audit readiness, and operational excellence.
This is a full-time, exempt leadership position reporting to the Director of Quality and Credentialing within the Compliance & Quality Department.
What You Will Do:
- Supervise day-to-day operations of the credentialing team, ensuring timely and accurate processing of initial and recredentialing files.
- Oversee verification of provider credentials including education, licensure, board certifications, and professional experience.
- Ensure all credentialing activities meet payer, accreditation, and regulatory standards (e.g., TJC, NCQA, AHCCCS/Medicaid, and commercial plans).
- Maintain the credentialing database and ensure provider data accuracy across CAQH, delegated payer rosters, and internal systems.
- Partner closely with Provider Enrollment to align credentialing workflows with payer onboarding.
- Monitor all expirable items (licenses, DEA, malpractice coverage) and manage renewal tracking.
- Prepare for audits and regulatory surveys; support compliance efforts with internal quality reviews.
- Lead credentialing committee preparation and reporting for executive leadership.
- Train, coach, and mentor team members to foster accountability, accuracy, and professional growth.
- Collaborate with HR, Provider Relations, Legal, and Clinical Leadership to streamline provider onboarding.
- Perform other duties as needed to support the success of the department.
What We Need From You:
- Associate’s degree required; Bachelor’s degree in a related field (e.g., Healthcare Administration, Business) preferred.
- Minimum of 5 years of leadership experience and at least 4 years in credentialing.
- Familiarity with public and private payers, including AHCCCS/Medicaid and commercial insurance plans.
- Knowledge of credentialing and compliance standards including TJC, NCQA, CMS, and state licensing boards.
- Experience with credentialing software and systems (e.g., CAQH, EMRs, payer portals).
- Strong time management, problem-solving, and communication skills.
- Ability to lead a team in a fast-paced, detail-oriented environment.
- Proficient with Microsoft Office Suite, especially Outlook, Word, and Excel.
- NAMSS certification (CPCS or CPMSM) preferred but not required.
Your Work Schedule:
- Full-Time: Monday to Friday, 9:00 AM – 5:00 PM
- Hybrid: In-office required on Wednesdays, with remote flexibility based on business needs
Perks of Being Part of Denova:
- Comprehensive low-cost medical, dental, and vision insurance.
- Generous retirement plan with a 3.5% company match.
- Secure your future with both long and short-term disability options
- Enjoy holiday pay, PTO, and life insurance benefits.
- We offer an employee wellness program and fantastic discounts for all Denova team members.
- And there's so much more waiting for you!
Denova Collaborative Health LLC is an integrated primary care and behavioral health practice based in the Greater Phoenix metropolitan area. Our comprehensive virtual care services are available for residents throughout the entire state of Arizona.
We provide a “whole person” approach to health and promote collaboration among our team of primary care providers and specialists. Our unique service integration of primary care, behavioral health, addiction medicine, and wellness enables our team to provide better health outcomes.
EEO & ADA Statements
Denova is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, disability status, sexual orientation, gender identity, age, protected veteran status or any other characteristic protected by law
ADA Statement
Denova Collaborative Health values and promotes diversity, equity, and inclusion, throughout its organization. Applicants with disabilities should email [email protected] to request accommodations in the hiring process.