Director, Credentialing & Accreditation

UR Ventures

. Provide operational and regulatory leadership for enterprise credentialing, recredentialing, clinical privileging, accreditation, and medical staff compliance activities .

Posted 10/8/2026full-timeRemote • New York • United StatesLead💰 $109,000 - $163,600 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in operational and regulatory leadership for credentialing, privileging, and accreditation processes, with a strong focus on compliance and performance management. Proven ability to lead teams, develop policies, and manage complex credentialing issues while ensuring adherence to regulatory standards.

Highest-signal resume keywords

Operational LeadershipRegulatory ComplianceCredentialing and PrivilegingPolicy DevelopmentTeam Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CredentialingPrivilegingAccreditationCompliance MonitoringPerformance MeasurementOperational Data AnalysisWorkflow ImprovementChange ManagementPolicy DevelopmentRisk Management

Soft Skills

Excellent CommunicationInterpersonal SkillsPresentation SkillsCoachingEvaluation

Certifications & Qualifications

CPMSM CertificationCPCS CertificationNAMSS Certification

Industry Keywords

TJCCMSNCQANew York State DOHOSHANPDBDelegated CredentialingOPPEFPPEMedical Staff Compliance

About the role

Key responsibilities & impact

Provide operational and regulatory leadership for enterprise credentialing, recredentialing, clinical privileging, accreditation, and medical staff compliance activities
Translate senior leadership direction into operational plans, performance expectations, policies, and controls
Oversee credentialing, privileging, certification/accreditation, and related operational managers
Serve as the primary escalation point for complex files, compliance concerns, and cross-functional issues
Partner with medical staff leaders, hospital administration, quality, compliance, legal, IT, payer enrollment, and affiliated organizations
Lead primary source verification, ongoing monitoring, application and file review, and timely approval workflows
Support operational planning, resource allocation, vendor and contract oversight, budget monitoring, risk management, and communications
Lead, coach, and evaluate managers, supervisors, and assigned staff
Direct readiness and compliance activities for TJC, CMS, NCQA, New York State DOH, OSHA, NPDB, delegated payers, and other standards
Oversee accreditation surveys, regulatory reviews, delegated credentialing audits, internal assessments, corrective action plans, and remediation
Develop, review, route, implement, and maintain credentialing, privileging, reappointment, monitoring, and accreditation policies and procedures
Oversee specialty-specific, criteria-based privilege forms and OPPE/FPPE processes
Prepare and review files, agendas, recommendations, and documentation for credentials committees, medical executive committees, and governing boards
Guide complex or adverse credentialing matters and monitor licenses, DEA registrations, board certifications, health requirements, sanctions, exclusions, and NPDB reports
Serve as subject matter expert and escalation resource for credentialing, privileging, accreditation, and medical staff compliance
Maintain professional knowledge through associations, education, conferences, and regulatory updates

Requirements

What you’ll need

Bachelor's degree in business, health care administration, health information management, or a related field and 6 years of progressively responsible experience in medical staff services, credentialing, privileging, and accreditation required
Equivalent combination of education and experience accepted
Demonstrated experience supporting regulatory surveys, accreditation reviews, delegated credentialing audits, policy development, corrective action plans, and sustained compliance monitoring required
Advanced knowledge of medical staff credentialing and privileging principles and applicable TJC, CMS, NCQA, DOH, OSHA, NPDB, and delegated credentialing requirements required
Demonstrated ability to establish performance measures, analyze operational data, improve workflows, manage change, and lead teams through organizational or technology transformation required
Excellent written, verbal, interpersonal, and presentation skills required
Master's degree preferred
Experience with OPPE/FPPE, criteria-based privilege development, medical staff committee and governing board processes, and complex credentialing issue resolution preferred
CPMSM certification preferred
CPCS certification preferred
Attainment of an applicable NAMSS certification within an organization-established timeframe preferred