Associate Director, Licensing & Credentialing

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Associate Director, Licensing & Credentialing Full Time Regular Management, Bakersfield, CA, US Salary Range: $97,760.00 To $136,052.80 Annually Clinica Sierra Vista is excited to be one of the largest Federally Qualified Health Centers in the Nation. We serve diverse communities and strive to keep patients as #1. Why work for us? Competitive pay which matches your abilities and experience Health coverage for you and your family Generous number of vacation days per year A robust wellness plan and health club discounts Continuing education assistance to grow and further your talents 403(b) plan with company matching Position Summary The Associate Director is responsible for leading the credentialing and licensing functions to ensure all providers and facilities meet Joint Commission, HRSA, federal, state, and payer requirements. This role provides day‑to‑day operational oversight, sets priorities, ensures efficient resource utilization, maintains high performance standards, and drives process improvement to support organizational goals. Essential Functions Facility Licensing Maintain working knowledge of licensing and credentialing requirements at the local, state, and federal levels. Apply for new business licenses, certifications, and registrations as required to support business operations. Maintain regulatory business information such as ownership, officers, EIN, Medicare, and NPI information. Establish and maintain tracking tools (e.g., SharePoint and Excel databases) and reporting to monitor licensure/registration status and compliance. Oversee tracking of licensure expiration dates and verify that professionally licensed individuals remain in good standing. Responsible for creating and tracking regulatory binders across lines of business. Complete assigned compliance training and other educational programs as required. Monitor the release of regulatory letters (e.g., DHCS, HRSA, CDPH) and route them to appropriate leadership with recommended actions as needed. Coordinate, prepare, and monitor special projects and reports as required. Ensure that all CSV clinics, CLIA, pharmacy, dispensary, and other operating licenses are current and renewed when due. Gather and verify information, review application requirements, and prepare and process documents. Evaluate requests, approve invoices, and manage license administrators. Partner with operations leadership to stay current on operational changes that impact licensing requirements and timelines. Manage and evaluate all regulations and legislations for licensing activities, ensure proper implementation, and prepare strategies for various business groups. Maintain information (license numbers, expiration dates, etc.) and obtain re‑registration approvals before license expirations to ensure no disruption. Review applications for new licenses or renewals of existing licenses, ensuring documentation is complete and accurate. Collaborate internally and externally in prioritizing licensing projects. Maintain and organize appropriate regulatory records to demonstrate compliance. Work closely with the compliance team to complete audits and prepare the site for regulatory visits. Understand and interpret California and federal healthcare regulations. Apply contract administration principles for healthcare systems. Understand ethics, principles, and practices of contract administration. Maintain knowledge of local, state, and federal licensing requirements. Credentialing Initiate and follow through on all aspects of credentialing, including initial and re‑credentialing for all practitioners and allied health staff. Initiate and conduct primary source verification of practitioner background, education/training, and malpractice history. Identify and evaluate potential red flags and partner with HR, compliance, and operational stakeholders. Perform ongoing monthly and quarterly compliance reporting—analyzing report data and state board sanction information. Prepare materials and files for presentation and review by the credentialing committee. Collaborate with inter‑departmental peers to implement best practices and ensure a consistent credentialing product. Partner with Human Resources, Operations, and Provider Recruitment to ensure timely credentialing of new providers prior to start dates. Recommend process and system improvements and maintain knowledge of NCQA and Joint Commission requirements. Ensure compliance with Joint Commission, NCQA standards, and other agencies; support policy and procedure development. Maintain accuracy and integrity of credentialing systems/data; leverage reporting and queries for workflow prioritization. Identify and address issues proactively, ensuring timely, compliant resolution and clear documentation. Demonstrate strong organizational skills and ability to manage multiple priorities, including expedited credentialing requests. Work cooperatively in a team environment to support the mission and vision of Clinica Sierra Vista. Build collaborative working relationships to advance the mission and vision. Submit completed credentialing applications to health plans for enrollment; track effective dates. Provide performance feedback, complete evaluations and competency documentation, and support employee development. Maintain consistent, reliable, and on‑site attendance as required. Team Leadership & Supervision Lead, mentor, and develop the licensing and credentialing team; set clear expectations, priorities, and service standards. Establish performance goals and accountability; provide coaching, feedback, and formal performance evaluations. Ensure appropriate staffing, training, and tools to meet timelines, quality standards, and audit‑readiness expectations. Ensure team adherence to organizational policies, regulatory requirements, and employment laws. Communicate status, risks, and priorities to leaders and stakeholders; elevate issues with recommendations. Drive a culture of service excellence, continuous improvement, and compliance across the team. Partner with cross‑functional teams to resolve complex issues, standardize workflows, and improve outcomes. Operational Oversight Oversee day‑to‑day operations for licensing and credentialing, ensuring work completion on time, accurately, and in alignment with policy and regulatory requirements. Define, monitor, and report key performance indicators and service level expectations for credentialing, enrollment, and licensing deliverables. Lead continuous improvement efforts to improve cycle time, reduce risk, and increase stakeholder satisfaction. Collaboration & Communication Build strong partnerships across departments to align priorities, clarify requirements, and ensure timely, compliant licensing and credentialing outcomes. Serve as primary point of contact for leadership on status, risks, and remediation plans. Coordinate with functional leaders to standardize processes, improve handoffs, and ensure consistent application of requirements. Problem‑Solving & Decision‑Making Resolve complex operational and personnel issues using sound judgement, policy, and regulatory requirements. Make decisions that balance compliance, operational efficiency, and business needs. Address internal stakeholder concerns related to credentialing, enrollment, and licensing. Lead key initiatives from planning through execution (e.g., payer onboarding, system changes, audit remediation). Allocate resources effectively and adjust priorities to meet commitments and minimize risk. Track progress, remove barriers, and implement corrective actions to keep work on schedule and in compliance. Reporting & Analysis Develop and deliver regular operational reporting to leadership (volumes, cycle times, aging, audit readiness, risk items) with recommendations. Analyze trends to identify root causes, improvement opportunities, and emerging compliance risks. Maintain accurate documentation and controls to support internal audits, external surveys, and regulatory reviews. Other duties as assigned or based on the needs of the organization. Qualifications Bachelor’s degree preferred. Five years of credentialing experience in a managed care setting or experience in the medical field with a thorough understanding of credentialing, privileging, and licensing. Proven ability to function independently with minimal supervision. Strong organizational and communication skills. Demonstrate organizational effectiveness and management leadership skills. Proficient in Microsoft Office Suite (Outlook, Word, Excel). Comfortable extracting and formatting data for ad hoc reports. Attention to detail. Confidentiality required. Knowledge of MD Staff (ASM) preferred. Significant working knowledge of accreditation standards (Joint Commission, HRSA, CDC, HIPAA, NCQA, CMS and state and federal compliance standards). Certification as Certified Provider Credentialing Specialist (CPCS). Requirements Must be able to work a full‑time schedule. Must be able to pass all pre‑employment screening (background check, drug tests, and references). Must be able to comply with organizational behavioral standards. Clinica Sierra Vista values human rights, goodwill, respect, inclusivity, and equality. We strive to create an inclusive environment that reflects these values and welcomes a diverse workforce. Clinica Sierra Vista is an equal opportunity employer and strives to attract qualified applicants from all walks of life without regard to race, color, ethnicity, religion, national origin, age, sex, sexual orientation, gender identity, gender expression, marital status, ancestry, physical disability, mental disability, medical condition, genetic information, military and veteran status, or any other status protected under federal, state, and/or local law. Attachments (1) ADMIN - Associate Director, Licensing & Credentialing.docx #J-18808-Ljbffr