Supervisor, Credentialing

• Direct supervision of the GBC Credentialing team and day-to-day task oversight of the offshore market team
• Training and onboarding for all team members: FTE, offshore, and contractor
• Quality oversight, audit follow-through, and corrective action
• Escalation routing, tracking, and closure for operational issues and leadership requests
• Ownership of training materials, SOPs, job aids, checklists, and the knowledge repository
• Hands-on ownership of the Priority Provider Readiness Program for leadership-approved priority providers

• Oversight of provider onboards and ancillary PIF management, with direct hands-on involvement limited to priority providers
• Payer packet auditing and PSV-ready packet standards
• Non-delegated submissions and follow-up
• Expirable management
• Oversight of ECHO builds, payer tracker maintenance, and Athena management standards
• Oversight and escalation support for claim and issue resolution tied to credentialing and market work

• Directly supervise all GBC Credentialing team members and set performance expectations aligned to organizational goals
• Conduct regular coaching sessions, one-on-ones, and performance evaluations
• Develop employee growth and succession planning strategies
• Foster a culture of accountability, collaboration, customer service, and continuous improvement
• Monitor productivity and quality performance metrics and manage workload distribution

• Serve as the go-to SME for all credentialing and market functions and explain the “why” behind each step, not just the clicks
• Understand and teach how market work depends on and feeds the PSV, Delegation, and Government teams
• Teach the differences between delegated, non-delegated, and government enrollment pathways, including where handoffs occur
• Complete the groundwork before drawing conclusions: review source materials, trace root cause, validate details, and assess full impact
• Validate that a process is current and correct before teaching it; confirm through the appropriate source rather than memory or habit

• Serve as the departmental owner of credentialing training and education
• Run structured onboarding for every new FTE, offshore, and contractor team member
• Create and maintain SOPs, job aids, audit checklists, competency assessments, and a centralized knowledge repository
• Host recurring re-trainings and “back to basics” refreshers targeted at identified gaps
• Coordinate cross-training initiatives to improve operational flexibility and coverage
• Hold weekly check-ins with trainees and offshore team members and track their progress
• Partner with the Credentialing Auditor and managers to identify individual and team weak spots using audit findings and quality trends, then report findings and recommended training actions to leadership
• Measure training effectiveness through accuracy, consistency, repeat-error reduction, and applied behavior; fold results into specialist reports shared with managers
• Ensure training aligns with organizational policies, payer requirements, and regulatory standards

• Partner with the Credentialing Auditor to review audit findings and quality trends; analyze recurring errors and identify root causes
• Develop, implement, and complete corrective action plans
• Audit team output for accuracy and provide direct, specific, real-time corrective feedback
• Partner with the manager to determine appropriate accountability, coaching, or follow-up
• Own process integrity and standardize “what good looks like” at each handoff point
• Implement process improvements that increase accuracy and efficiency, and maintain readiness for internal and external audits

• Serve as the hands-on owner for leadership-approved priority providers
• Develop and personally maintain readiness plans, milestone tracking, risks, and escalations for assigned priority providers

Coordinate activities across:

• Credentialing and Provider Enrollment
• Contracting and Network Development
• Revenue Cycle
• Practice Operations and Provider Onboarding
• Escalate barriers that threaten provider readiness timelines
• Provide leadership visibility through readiness reporting and dashboards
• Drive priority providers toward credentialed, enrolled, and billing-ready status by their first day whenever payer and operational requirements allow

• Treat onboarding timelines, PEA/PSA execution windows, roster deadlines, and leadership requests as time-sensitive priorities
• Acknowledge leadership requests promptly, clarify priority, and confirm next steps
• Prioritize supervisory follow-up based on risk, deadline sensitivity, and downstream impact to providers, markets, and partner teams; directly work priority provider barriers when assigned
• Monitor aging work, missing packet items, and open follow-ups, and reinforce urgency across the team
• Reinforce escalation pathways, route issues to the correct owner, and follow up to confirm resolution
• Investigate issues fully before presenting to leadership: gather context, validate facts, identify root cause and impact, and bring a recommended next step
• Identify trends and barriers early and partner with the appropriate owner to mitigate risk before escalation
• Communicate professionally with market leaders, peers, and cross-functional partners, and provide proactive updates on urgent items until completion

• Monitor credentialing pipeline performance and readiness metrics
• Develop operational reports and dashboards, and ensure adherence to established SLAs
• Provide regular reporting to managers and leadership on open issues, training progress, team knowledge levels, recurring trends, quality concerns, and recommended next steps
• Provide supervisory, training, and workflow insights that support a repeatable, scalable onboarding path for a growing offshore, contractor, and FTE workforce
• Share quality trends and training outcomes to help define KPIs and quality standards as the team expands
• Maintain a forward-looking training roadmap and support strategic initiatives and organizational growth

• Ensure compliance with NCQA standards, delegated credentialing agreements, CMS regulations, organizational policies, and payer requirements
• Maintain current knowledge of industry regulations and best practices
• Support accreditation reviews and audit activities

Knowledge, Skills, Abilities

Required: 

• Advanced knowledge of provider credentialing and enrollment operations and payer onboarding requirements
• Strong organization, prioritization, project management, and follow-through on time-sensitive work
• Ability to analyze data and identify operational trends
• Strong leadership, coaching, and employee development skills
• Excellent written and verbal communication and stakeholder management with leaders and cross-functional partners
• Proficiency in Microsoft Office applications