Principal Credentialing Specialist

Description

Play a vital role in ensuring the delivery of safe, high-quality patient care by leading UCLA Health's centralized credentialing operations. As a Principal Credentialing Specialist, you'll oversee credentialing, privileging, onboarding, and enrollment activities for physicians and allied health practitioners across UCLA's hospitals and community partners. You'll provide technical expertise, operational oversight, and mentorship to the credentialing team while maintaining compliance with regulatory standards and institutional policies.

Key Responsibilities

Supervise 10-22 credentialing staff and oversee day-to-day operations of the Centralized Credentialing Unit in managers' absence

Manage onboarding, credentialing, and payer enrollment for UCLA hospitals, medical groups, and 90+ community hospital partners

Analyze hospital bylaws, proctoring requirements, and privilege criteria to ensure compliance and timely provider onboarding

Lead process improvement initiatives, workflow optimization, and training programs to enhance departmental efficiency

Maintain and optimize the credentialing database (MD-Staff) and ensure data accuracy across all systems

Prepare, review, and distribute credentialing reports and summaries for medical staff committees

Oversee financial activities including CVO payments, membership dues, and credentialing-related expenditures

Serve as a resource and subject matter expert on credentialing policies, bylaws, and accreditation standards

Salary Range : $70,900 - $145,200 / Annually

Qualifications

We're seeking an independent, deadline-driven professional with :

• Bachelor's degree in a relevant field with 5 years of experience or a combination of equivalent years of education, training and experience; Master's degree preferred
• Certified Provider Credentialing Specialist (CPCS) and Certified Professional Medical Services Management (CPMSM) preferred
• Five years of experience in physician and advanced healthcare credentialing required
• Expert knowledge of regulatory best practices, credentialing operations, and administrative processes, with the ability to identify and implement improvements
• Advanced analytical and critical thinking skills to manage complex, long-term projects and develop innovative solutions
• Strong organizational and project management abilities, capable of prioritizing multiple assignments and meeting deadlines in a dynamic environment
• Professional demeanor and leadership presence, exercising discretion, diplomacy, and sound judgment under pressure.
• Technical proficiency in Microsoft Office Suite and credentialing database systems, with advanced skills in data analysis, reporting, and compliance tracking
• Exceptional communication skills, both written and verbal, fostering collaboration and transparency across all levels of the organization
• Broad understanding of related disciplines including legal, IT, performance improvement, risk management, and HR principles.
• Integrity and ethical leadership, consistently modeling accountability, fairness, and professionalism while building trust and strong partnerships