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Sr. Director, Credentialing

Role overview

Qualifications

  • 8+ years of progressive healthcare credentialing, enrollment, and provider operations experience
  • 5+ years of management experience required in a credentialing/enrollment environment
  • Demonstrated experience leading enterprise-scale credentialing operations across multiple states, practices, or provider groups
  • Bachelor’s degree required

Responsibilities

  • Provide strategic leadership for enterprise-wide credentialing, provider enrollment, and licensing operations
  • Develop and execute a long-term credentialing and enrollment strategy
  • Lead, mentor, and develop a high-performing leadership team
  • Establish organizational performance standards and key performance indicators for credentialing and enrollment operations

Key facts

Hard skills

Other skills

  • Collaboration
  • Accountability

About the company

OneOncology logo

OneOncology

Medical Practices & Clinics

OneOncology is a partnership of independent community oncology practices committed to driving the future of cancer care delivery through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. OneOncology empowers community oncology practices by supporting the entire continuum of care, including prevention and diagnosis, research and treatment, and long-term survivorship, palliative, and hospice care. Our technology provides access to key clinical and operational data and the latest research via a cloud-based network. This comprehensive approach supports community oncologists’ transition to value-based care and commitment to providing their patients with access to best-in-class healthcare, close to home. For OneOncology, cancer is personal, and the mission is critical. Working together with world class oncologists, OneOncology looks to drive the change that community cancer needs through continual learning, creative and smart evolution, and a collective desire to positively impact the lives of every person touched by cancer. To learn more, visit www.oneoncology.com or follow us on Twitter @OneOncology.

Company details

IndustryMedical Practices & Clinics
Company size1001 - 5000

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Job description

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision.

Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.

Job Description:

Role Summary: 
The Senior Director, Credentialing will report to OneOncology’s VP, RCM Practice Services and is responsible for the strategic leadership, operational performance, and continuous advancement of enterprise credentialing, enrollment, licensing, privileging, and provider onboarding functions across the OneOncology platform.

The Senior Director will be responsible for setting performance expectations and ensuring adherence to agreed upon metrics for the Credentialing Team.  They will provide oversight and best practices for all credentialing related work while complying with state and federal standards. The Senior Director will also be responsible for developing and maintaining advanced workflows that leverage automation to reduce manual tasks.  Additional responsibilities include developing executive-level dashboards and communicating performance to the key stakeholders providing real-time status updates as appropriate.

Responsibilities:

  • Provide strategic leadership for enterprise-wide credentialing, provider enrollment, and licensing operations, ensuring scalable, compliant, and efficient processes that support organizational growth across multiple markets, practice locations, and payer networks.

  • Develop and execute a long-term credentialing and enrollment strategy that accelerates provider onboarding, minimizes revenue disruption, and enhances the overall provider experience across the OneOncology platform.

  • Lead, mentor, and develop a high-performing leadership team, fostering a culture of accountability, continuous improvement, and operational excellence.

  • Establish organizational performance standards and key performance indicators for credentialing and enrollment operations, driving transparency, accountability, and measurable business outcomes across the enterprise.

  • Serve as the executive sponsor for provider onboarding initiatives, ensuring alignment among credentialing, revenue cycle, operations, compliance, payers, and practice leadership to achieve timely provider activation and revenue readiness.

  • Direct the development, implementation, and governance of credentialing, enrollment, and licensing policies and procedures, ensuring compliance with federal, state, payer, accreditation, and regulatory requirements.

  • Champion large-scale process transformation initiatives that optimize credentialing workflows, reduce cycle times, enhance service delivery, and drive operational efficiencies across the organization.

  • Lead strategic technology adoption efforts, partnering with internal stakeholders and external vendors to evaluate, prioritize, and implement innovative solutions that improve automation, data integrity, reporting capabilities, and operational scalability.

  • Act as the executive subject matter expert for credentialing, enrollment, licensing, and provider onboarding, advising senior leadership on strategic initiatives, regulatory developments, operational risks, and growth opportunities.

  • Establish enterprise reporting and analytics strategies that provide actionable insights into credentialing performance, onboarding timelines, payer engagement, compliance metrics, and revenue impact, supporting informed executive decision-making.

  • Partner with Revenue Cycle Management leadership to establish proactive governance structures that identify and resolve credentialing-related reimbursement risks, optimize payer enrollment performance, and reduce revenue leakage associated with credentialing and enrollment deficiencies.

  • Drive cross-functional collaboration among Operations, Revenue Cycle, Compliance, HR, IT, Legal, and Practice Leadership to ensure credentialing and enrollment capabilities effectively support enterprise growth strategies, acquisitions, and market expansion initiatives.

  • Lead organizational readiness and integration efforts for mergers, acquisitions, and new practice partnerships, ensuring seamless credentialing, licensing, payer enrollment, and provider onboarding transitions that support business continuity and financial performance.

  • Develop and maintain enterprise risk management frameworks for credentialing and enrollment operations, proactively identifying compliance vulnerabilities, operational bottlenecks, and payer-related challenges while implementing sustainable mitigation strategies.

  • Represent credentialing and enrollment operations in executive leadership discussions, contributing strategic insights that support enterprise objectives, organizational growth, operational excellence, and long-term value creation.

Qualifications:

  • 8+ years of progressive healthcare credentialing, enrollment, and provider operations experience

  • 5+ years of management experience required in a credentialing/enrollment environment

  • Demonstrated experience leading enterprise-scale credentialing operations across multiple states, practices, or provider groups

  • Proven track record of leading organizational transformation and process improvement initiatives

  • Expertise of enrollment processes with Commercial and Government payors

  • Experience supporting mergers, acquisitions, practice integrations, or rapid organizational growth preferred

  • Experience operationalizing ASC-based credentialing/privileging and/or delegation agreements is preferred

  • Bachelor’s degree required

  • This position is remote based with 25% travel expected

This job description does not contain a full listing of activities, duties or responsibilities required for this role. Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.

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Marcus Rivera

Chief Revenue Officer

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linkedin.com/in/marcusrivera
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