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Clinical Credentialing, Privileging, & Enrollment Supervisor

Overview

The Credentialing & Privileging Supervisor oversees the full lifecycle of provider credentialing, recredentialing, and privileging for all licensed, certified, and other clinical staff. This role ensures compliance with California regulations, HRSA FTCA requirements, Medicare/Medicaid enrollment, payer credentialing, and NCQA/Joint Commission standards. The supervisor leads credentialing staff, manages workflows, ensures data accuracy, and collaborates with leadership, providers, and external agencies to maintain timely and compliant credentialing processes.

Required Qualifications

+ Bachelor’s degree in business or healthcare administration or related field or 5 years’ experience in hospital and/or healthcare credentialing in lieu of education

+ Must have Medical Staff Services certification: Certified Professional Medical Services Management (CPMSM), Certified Provider Credentialing Specialist (CPCS), or Certified Professional Medical Services Management (CPMSM) credential from National Association Medical Staff Services (NAMSS)

+ Knowledge of credentialing rules and regulations, as well as accrediting organization standards, Center for Medicare and Medicaid Services (CMS) regulations, state regulations, and other regulatory agencies as they pertain to medical staff and allied health professionals

+ Knowledge and experience with audits from TJC, FTCA, plans/IPA, etc.

+ Minimum 1–2 years of supervisory or lead experience in credentialing

+ Demonstrated ability to supervise up to 5 employees

+ Experience working in Human Resources department

+ Able to communicate effectively in English, both verbally and in writing

+ Fluency in additional languages preferred

+ Excellent interpersonal skills

+ Knowledge of basic anatomy and physiology, medical terminology, and functions of medical staff services

+ Advanced computer skills in word processing, spreadsheets, and databases

+ Excellent organizational skills

+ Must be willing to successfully complete the credentialing process

Essential Responsibilities

+ Oversees the credentialing & privileging process to ensure that all individuals credentialed and/or granted clinical privileges are qualified to provide patient care, treatment, and services based upon the scope of their training, licensure, and experience

+ Supervises the Credentialing & Enrollment team to ensure optimum performance of the department

+ Functions as a member of Human Resources and acts as the subject matter expert for credentialing, privileging, and enrollment

+ Ensures compliance with rules and regulations, allied health professionals’ policies, other policies and procedures, and appropriate regulatory agency standards

+ Audits, supervises, and evaluates processes involved in verifications for licensed and certified providers and allied health professionals’ applications, appointments, reappointments, and privilege delineation

+ Coordinates the processing of candidates’ applications that require credentialing & privileging. Assures that all applications are processed completely and in a timely manner in accordance with HR guidelines

+ Audits applications, reviews supporting documents, including all primary source verification for all credentialing and re-credentialing to ensure allied health professional files are current and policies and procedures are followed to obtain required documentation and verification

+ Coordinates activities, provides statistical information, and explains procedures to facilitate the reappointment process

+ Maintains and monitors confidential information for credentialing, HR, and peer review discussions and other sensitive matters

+ Organizes and supports the Credentialing Committee

+ Responsible for assuring that the findings, conclusions, and recommendations for actions to appoint or reappoint applicants and/or improve the credentialing program are reported through appropriate leadership, and that approved actions are then assigned and/or implemented in a timely manner

+ Improves professional growth and knowledge of job to maintain efficiency and effectiveness of the Credentialing department by belonging to professional organizations, attending seminars, and reading journals and publications

+ Assures the ongoing development and implementation of policies and procedures that guide and support the provision of services

+ Possesses working knowledge of state and federal law relating to due process and provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and accrediting organization standards

+ Supports and maintains a culture of safety and quality

+ Other duties as assigned

Benefits

Successful candidate will receive regionally competitive salary, above-average health benefits at reduced costs, company-paid life insurance & long-term disability insurance, additional voluntary retirement plan with company match and no vesting schedule requirement. Dependent on working 30+ hours per week.

+ Paid bereavement and jury duty leave

+ 11 paid holidays per year

+ Paid time off

+ Paid sick leave

+ Flexible Spending Program

+ Professional development hours offered annually

Job Type & Location

This is a Permanent position based out of Sacramento, CA.

Pay and Benefits

The pay range for this position is $87360.00 - $100000.00/yr.

WellSpace Health offers comprehensive employee benefits including medical, dental, vision, and prescription coverage, plus life/disability insurance, generous paid time off, continuing education support, retirement plans (401k), an Employee Assistance Program (EAP), and wellness perks like legal/identity theft protection, making it attractive for work-life balance and professional growth

Workplace Type

This is a fully onsite position in Sacramento,CA.

Application Deadline

This position is anticipated to close on Jan 15, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email [email protected] (%[email protected]) for other accommodation options.