Director of Credentialing & Compliance

About Assured

Assured is a technology-driven provider operations company on a mission to reduce healthcare costs by automating provider network management. Our all-in-one platform streamlines credentialing, licensing, payer enrollment, and compliance workflows, helping healthcare organizations eliminate administrative burdens, guesswork, and inefficiencies. By merging cutting-edge AI with deep domain expertise, we dramatically cut provider onboarding time (from 60+ days to as fast as 2 days) while improving accuracy and transparency. As an NCQA-certified Credentials Verification Organization (CVO), we uphold the highest industry standards for data accuracy and regulatory compliance. Assured is trusted by leading provider groups, health systems, payers, and digital health companies to manage their provider networks with speed, precision, and confidence.

Role Summary

We are seeking an experienced Director of Credentialing & Compliance to lead our credentialing/CVO operations and ensure excellence in quality and compliance. In this strategic role, you will serve as Assured’s credentialing thought leader and subject-matter expert, guiding the development of best-in-class credentialing workflows for a variety of clients from different health organizations (health systems, hospitals, MSOs, IPAs, and health plans). You will manage and mentor our internal credentialing team, enforce high-quality standards, and drive continuous improvement in our processes. You will also be the owner of compliance – maintaining alignment with NCQA standards and staying ahead of updates from NCQA, URAC, HICE, and Joint Commission to keep our policies and platform in line with the latest requirements. This is a unique opportunity to use your deep credentialing expertise to guide the design of our innovative automation platform and transform provider credentialing.

Responsibilities

• Oversight of End-to-End Credentialing Processes: Direct and manage all aspects of the credentialing operations from initiation to completion.
• Maintenance of Regulatory Compliance and Audit Preparedness: Ensure adherence to all applicable standards and regulations, and establish procedures to maintain audit readiness.
• Leadership and Development of Staff: Supervise, mentor, and train credentialing personnel to achieve organizational goals and maintain high performance.
• Quality Assurance and Process Enhancement: Implement quality control measures and drive continuous improvement initiatives to optimize operational efficiency.
• Cross-functional Collaboration: Facilitate effective communication and cooperation with our Product, Customer Success, and Operations teams to ensure seamless workflow integration.
• Subject Matter Expertise and Industry Engagement: Serve as the principal authority on credentialing matters with our clients, actively participate in industry forums, and disseminate relevant knowledge.
• Strategic Planning and Execution: Develop and implement quarterly strategic plans for credentialing operations that align with organizational objectives, including development & tracking of relevant KPIs & SLAs, headcount planning & product roadmap feedback.

Qualifications

• 7+ years of experience in healthcare provider credentialing or CVO operations, with a deep understanding of primary source verification (PSV), delegated credentialing, and medical staff privileging (CPCS or CPMSM certification preferred)
• Strong expertise in NCQA credentialing standards
• Familiarity with URAC accreditation, the Health Industry Collaboration Effort (HICE), and Joint Commission credentialing standards
• Hands-on experience preparing for and passing both NCQA & payor audits
• Demonstrated ability to lead and develop a team
• Proven aptitude for process improvement and workflow automation
• Excellent communication and collaboration skills

Why Assured? 

• True ownership: you will get to define the vision & direction for Assured’s Credentialing and Compliance verticals. 
• Be at the cutting edge: contribute to Assured’s mission to eliminate providers’ administrative burdens by combining human & AI expertise. 
• Strong, collaborative team: join a dedicated, mission-driven team aiming to transform provider operations. 
• Rapid growth: directly support our growing portfolio of clients with backing from top healthcare investors. 
• People-first benefits: enjoy comprehensive health coverage and flexible PTO that supports your wellbeing inside and outside of work.