Senior Credentialing Associate

Position Summary

The Sr. Credentialing Associate oversees the end-to-end credentialing, recredentialing, and privileging processes for all licensed clinical staff at The Dimock Center, ensuring compliance with HRSA, Joint Commission, NCQA, state, and federal regulatory requirements. This role manages provider credentialing files, maintains accurate records in credentialing databases, coordinates with internal departments and external agencies, and ensures timely completion of all credentialing activities to support patient safety and operational readiness.

The Sr. Credentialing Associate supports the Risk Manager in facilitating the Credentialing Committee, ensuring all provider applications and renewals are reviewed, documented, and approved in accordance with organizational bylaws and regulatory standards.

Additionally, this individual serves as the primary point of contact for external partners to assist in ensuring appropriate credentialing and privileging of our providers.

Essential Duties & Responsibilities

Credentialing & Recredentialing

• Manage and execute the full lifecycle of credentialing and recredentialing for all clinical staff at the Health Center and Addiction Medicine Division.
• Oversee privileging process in accordance with organizational policies and applicable accrediting body standards.
• Ensure all clinical staff credentialing files are accurate, complete, and meet internal and external compliance standards.
• Maintain credentialing database(s) and generate reports for the Associate Chief Compliance & Enterprise Risk Officer and Risk Manager, regulatory agencies, and audits.

Compliance & Regulatory Oversight

• Ensure compliance with HRSA, NCQA, Joint Commission, CMS, OSHA, HIPAA, and other applicable regulations.
• Monitor license, certification, and DEA expirations; coordinate timely renewals.
• Stay informed of changes in credentialing requirements and update policies, procedures, and systems accordingly.
• Prepare for and participate in audits and site visits by regulatory and accrediting bodies.

Credentialing Committee Coordination and Support

• Prepare Credentialing Committee agendas, clinical staff files, and supporting documentation in advance of meetings.
• Assist the Risk Manager with preparing credentialing and privileging recommendations to the Committee.
• Record meeting minutes, track follow-up actions, and ensure timely documentation of Committee decisions.
• Ensure all Credentialing Committee activities meet organizational bylaws, HRSA requirements, and accrediting body standards.

Provider Contract and Credentialing Coordination

• Assist the HR Manager with the preparation, review, and execution of provider employment contracts for both new hires and renewals.
• Coordinate contract execution to support timely onboarding, credentialing, and privileging processes.
• Maintain accurate records of provider contracts and track renewal dates to avoid lapses.
• Communicate contract details and requirements to providers, HR, and relevant department leaders.
• Assist in streamlining provider onboarding workflows by aligning contract completion with credentialing timelines.
• Support compliance by ensuring provider contracts reflect current accreditation and HRSA requirements.

External Partner Coordination

• Serve as the primary point of contact for external partners regarding credentialing and privileging requirements for providers.
• Coordinate with partner institutions to exchange necessary documentation, verify credentials, and ensure compliance with both organizations’ standards.
• Address and resolve credentialing-related issues in collaboration with partner organizations.