Supervisor, Credentialing

The Supervisor, Credentialing Operations, Training & Provider Readiness leads the GBC Credentialing team and serves as the subject matter expert (SME), trainer, and day-to-day oversight lead for credentialing and market operations. This role is accountable for building team knowledge, driving urgency, and protecting the accuracy and timeliness of credentialing work so providers are onboarded, enrolled, and billing-ready without delaying their ability to generate revenue.

This role owns training, onboarding, continuous education, and staff development for the department. Using audit findings, operational trends, and performance data, it proactively identifies opportunities to improve competency, reduce errors, and increase consistency.

The Supervisor also directly manages the organization's Priority Provider Readiness Program as a hands-on individual contributor for leadership-approved priority providers, ensuring designated providers move through the credentialing and enrollment pipeline and are fully billing-ready on Day One whenever payer and operational requirements allow.

This is a hybrid leadership role. The supervisor serves as an individual contributor for leadership-approved Priority Providers, directly managing those high-risk readiness plans through completion. For broader team operations, success is measured by how effectively the supervisor leads, trains, monitors, and improves team performance, including accuracy, consistency, turnaround, and reduced critical misses. The supervisor redirects routine work to the correct owners, removes barriers, and oversees quality rather than personally completing all team-assigned work.

• Direct supervision of the GBC Credentialing team and day-to-day task oversight of the offshore market team
• Training and onboarding for all team members: FTE, offshore, and contractor
• Quality oversight, audit follow-through, and corrective action
• Escalation routing, tracking, and closure for operational issues and leadership requests
• Ownership of training materials, SOPs, job aids, checklists, and the knowledge repository
• Hands-on ownership of the Priority Provider Readiness Program for leadership-approved priority providers

• Oversight of provider onboards and ancillary PIF management, with direct hands-on involvement limited to priority providers
• Payer packet auditing and PSV-ready packet standards
• Non-delegated submissions and follow-up
• Expirable management
• Oversight of ECHO builds, payer tracker maintenance, and Athena management standards
• Oversight and escalation support for claim and issue resolution tied to credentialing and market work

• Directly supervise all GBC Credentialing team members and set performance expectations aligned to organizational goals
• Conduct regular coaching sessions, one-on-ones, and performance evaluations
• Develop employee growth and succession planning strategies
• Foster a culture of accountability, collaboration, customer service, and continuous improvement
• Monitor productivity and quality performance metrics and manage workload distribution

• Serve as the go-to SME for all credentialing and market functions and explain the “why” behind each step, not just the clicks
• Understand and teach how market work depends on and feeds the PSV, Delegation, and Government teams
• Teach the differences between delegated, non-delegated, and government enrollment pathways, including where handoffs occur
• Complete the groundwork before drawing conclusions: review source materials, trace root cause, validate details, and assess full impact
• Validate that a process is current and correct before teaching it; confirm through the appropriate source rather than memory or habit

• Serve as the departmental owner of credentialing training and education
• Run structured onboarding for every new FTE, offshore, and contractor team member
• Create and maintain SOPs, job aids, audit checklists, competency assessments, and a centralized knowledge repository
• Host recurring re-trainings and “back to basics” refreshers targeted at identified gaps
• Coordinate cross-training initiatives to improve operational flexibility and coverage
• Hold weekly check-ins with trainees and offshore team members and track their progress
• Partner with the Credentialing Auditor and managers to identify individual and team weak spots using audit findings and quality trends, then report findings and recommended training actions to leadership
• Measure training effectiveness through accuracy, consistency, repeat-error reduction, and applied behavior; fold results into specialist reports shared with managers
• Ensure training aligns with organizational policies, payer requirements, and regulatory standards

• Partner with the Credentialing Auditor to review audit findings and quality trends; analyze recurring errors and identify root causes
• Develop, implement, and complete corrective action plans
• Audit team output for accuracy and provide direct, specific, real-time corrective feedback
• Partner with the manager to determine appropriate accountability, coaching, or follow-up
• Own process integrity and standardize “what good looks like” at each handoff point
• Implement process improvements that increase accuracy and efficiency, and maintain readiness for internal and external audits

• Serve as the hands-on owner for leadership-approved priority providers
• Develop and personally maintain readiness plans, milestone tracking, risks, and escalations for assigned priority providers

Coordinate activities across:

• Credentialing and Provider Enrollment
• Contracting and Network Development
• Revenue Cycle
• Practice Operations and Provider Onboarding
• Escalate barriers that threaten provider readiness timelines
• Provide leadership visibility through readiness reporting and dashboards
• Drive priority providers toward credentialed, enrolled, and billing-ready status by their first day whenever payer and operational requirements allow

• Treat onboarding timelines, PEA/PSA execution windows, roster deadlines, and leadership requests as time-sensitive priorities
• Acknowledge leadership requests promptly, clarify priority, and confirm next steps
• Prioritize supervisory follow-up based on risk, deadline sensitivity, and downstream impact to providers, markets, and partner teams; directly work priority provider barriers when assigned
• Monitor aging work, missing packet items, and open follow-ups, and reinforce urgency across the team
• Reinforce escalation pathways, route issues to the correct owner, and follow up to confirm resolution
• Investigate issues fully before presenting to leadership: gather context, validate facts, identify root cause and impact, and bring a recommended next step
• Identify trends and barriers early and partner with the appropriate owner to mitigate risk before escalation
• Communicate professionally with market leaders, peers, and cross-functional partners, and provide proactive updates on urgent items until completion

• Monitor credentialing pipeline performance and readiness metrics
• Develop operational reports and dashboards, and ensure adherence to established SLAs
• Provide regular reporting to managers and leadership on open issues, training progress, team knowledge levels, recurring trends, quality concerns, and recommended next steps
• Provide supervisory, training, and workflow insights that support a repeatable, scalable onboarding path for a growing offshore, contractor, and FTE workforce
• Share quality trends and training outcomes to help define KPIs and quality standards as the team expands
• Maintain a forward-looking training roadmap and support strategic initiatives and organizational growth

• Ensure compliance with NCQA standards, delegated credentialing agreements, CMS regulations, organizational policies, and payer requirements
• Maintain current knowledge of industry regulations and best practices
• Support accreditation reviews and audit activities

Knowledge, Skills, Abilities

Required:

• Advanced knowledge of provider credentialing and enrollment operations and payer onboarding requirements
• Strong organization, prioritization, project management, and follow-through on time-sensitive work
• Ability to analyze data and identify operational trends
• Strong leadership, coaching, and employee development skills
• Excellent written and verbal communication and stakeholder management with leaders and cross-functional partners
• Proficiency in Microsoft Office applications