Credentialing and Privileging Specialist
Free account needed to apply or save. It takes a minute, and we'll bring you right back to this job.
How well do you match this job?
Key details
- Location
- Indianapolis, IN, United States
- Work style
- Onsite
- Level
- Mid level
- Function
- People / HR & Recruiting
- Focus area
- other
- Posted
- 12h ago
Skills
About the role
Empowering communities through accessible, inclusive, and compassionate care, this is the work we do every day.
At Jane Pauley Community Health Center, every role is connected to something bigger. As a Federally Qualified Health Center (FQHC), we deliver integrated, whole-person care to individuals and families across Indiana, regardless of income or insurance status.
Our teams work at the intersection of clinical excellence and community impact, supporting underserved populations while building a culture rooted in collaboration, respect, and growth. Here, you are not just joining a workplace, you are becoming part of a mission that truly matters.
Position Summary
Reporting to the Chief Human Resources Officer, the Credentialing and Privileging Specialist ensures that all licensed independent practitioners and advanced practice providers, including physicians, nurse practitioners, physician assistants, dentists, behavioral health clinicians, and other clinicians, are properly onboarded, privileged, and credentialed before providing patient care. The specialist manages the full provider lifecycle: initial credentialing, privileging, re-credentialing, onboarding, and ongoing monitoring. The role supports compliance with HRSA Health Center Program requirements, FTCA deeming standards, accreditation standards, and payer requirements. The specialist works in close partnership with the Chief Medical Officer and clinical leadership, who holds authority over clinical privileging decisions, and reports credentialing and onboarding status to senior and executive leaders.
Key Responsibilities
Onboarding
- Coordinate and track provider and clinical staff onboarding from offer acceptance through first day of patient care, in alignment with HR hiring and onboarding processes.
- Partner with Talent Acquisition, Compliance, IT, Clinical Operations, Revenue Cycle, and site leadership to ensure all onboarding steps are completed. These include, for example, employment verification, background checks, health screenings and immunizations, required trainings, EHR access, badging, orientation, and competency validations.
- Confirm that no provider begins independent patient care until credentialing, privileging, and onboarding requirements are fully met.
- Maintain onboarding checklists, identify bottlenecks, and drive timely completion to support provider start dates.
Credentialing and Re-credentialing
- Process initial credentialing applications for all providers in accordance with organizational policies, HRSA requirements, and applicable accreditation standards.
- Manage the re-credentialing cycle, ensuring every provider is re-credentialed and re-privileged on schedule (at least every two years for FTCA-covered providers, or per organizational policy and accreditation requirements).
- DEA and state-controlled substance registrations, work history, malpractice history, and hospital affiliations or admitting arrangements.
- Query the National Practitioner Data Bank (NPDB), OIG List of Excluded Individuals/Entities, SAM.gov, and state Medicaid and Medicare exclusion databases at appointment, at re-credentialing, and on a continuous or monthly basis.
- Follow up on gaps, discrepancies, or adverse findings and escalate concerns promptly to the CHRO, CMO, and compliance leadership.
- Maintain accurate, complete, and confidential credentialing and privileging files.
Privileging
- Coordinate the delineation of clinical privileges with the CMO and clinical leaders, based on training, experience, and demonstrated competence, aligned with the scope of services in the health center's HRSA-approved scope of project.
- Prepare provider files for review and approval by the CMO, Credentialing Committee, and Governing Board (or per bylaws).
- Track focused and ongoing professional practice evaluations (FPPE/OPPE), performance reviews, and peer review documentation required for re-privileging, obtaining clinical input from the CMO and designated peer reviewers.
- Manage temporary privileges, ensuring proper documentation and timely close-out.
FTCA and HRSA Compliance
- Maintain credentialing and privileging files that meet FTCA deeming requirements and HRSA's Policy Information Notice (PIN) on credentialing and privileging.
- Support the annual FTCA deeming application and renewal process, including provider data and documentation.
- Assist with HRSA Operational Site Visits (OSV), audits, and corrective action plans related to credentialing, privileging, and onboarding.
- Track compliance with applicable Joint Commission, AAAHC, or NCQA standards, as well as state and federal regulations.
Monitoring and Tracking
- Track expiration dates for licenses, certifications (e.g., BLS, ACLS), DEA registrations, malpractice or FTCA coverage, and other time-sensitive credentials, and send timely reminders to providers and managers.
- Maintain a master tracking system across all sites and provider types, with proactive alerts for upcoming expirations and re-credentialing due d