Credientialing & Clinical Quality Coordinator

We are seeking a highly organized and detail-oriented Credentialing & Clinical Quality Coordinator to support medical staff services, provider credentialing, quality initiatives, and regulatory readiness within a growing healthcare organization. This non-clinical administrative role partners closely with physician leaders, clinical leadership, and interdisciplinary teams to ensure excellence in credentialing operations, performance monitoring, and compliance standards.

Position Summary

The Credentialing & Clinical Quality Coordinator supports practitioner credentialing and privileging processes, ongoing provider evaluations, peer review coordination, quality reporting, accreditation readiness, and performance improvement initiatives. This role does not provide patient care or make clinical decisions. All credentialing determinations, privileging approvals, and peer review judgments remain the responsibility of designated committees and governing bodies.

Key Responsibilities

Credentialing & Medical Staff Services

• Coordinate initial appointments, reappointments, and privileging processes for physicians, advanced practice providers, and allied health professionals.
• Perform primary source verification of licensure, education, training, board certification, DEA registration, malpractice history, sanctions, and employment history.
• Maintain credentialing files, databases, and tracking systems for expirables such as licenses, certifications, insurance, and required training.
• Prepare files and documentation for committee review and approval processes.

Quality & Clinical Performance

• Support data collection, tracking, and reporting for provider performance evaluations, peer review processes, and quality metrics.
• Coordinate dashboards, scorecards, and executive reports related to patient safety, quality outcomes, and operational performance.
• Assist leadership with quality improvement initiatives using structured process improvement methodologies.
• Support event reporting systems, trend analysis, and follow-up actions.

Accreditation & Compliance

• Support readiness efforts for regulatory surveys and accreditation agencies.
• Conduct audits of documentation, compliance indicators, and policy adherence.
• Maintain organized records and documentation to meet legal, regulatory, and retention standards.
• Monitor changes in healthcare regulations and communicate updates to leadership teams.

Administrative & Committee Support

• Prepare meeting agendas, minutes, action-item tracking, and committee materials.
• Coordinate cross-functional meetings involving medical staff, quality, safety, and operations teams.
• Maintain policy and procedure libraries, version control, review cycles, and approvals.

Qualifications

Education

• Bachelor’s degree in Healthcare Administration, Public Health, Business Administration, Health Information Management, or related field required.
• Master’s degree preferred.

Experience

• 3–5 years of experience in credentialing, medical staff services, healthcare quality, accreditation readiness, or related healthcare administration required.
• Direct provider credentialing experience strongly preferred.
• Experience in specialty hospital, rehabilitation, behavioral health, or complex-care settings preferred.

Skills

• Strong analytical, organizational, and data management skills.
• Advanced Microsoft Excel and Microsoft Office proficiency.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities with strong attention to detail.
• High level of professionalism and discretion with confidential information.

Preferred Certifications

• CPCS
• CPMSM
• CPHQ

Why Join Us?

This is an opportunity to join a mission-driven healthcare organization focused on operational excellence, quality outcomes, and continuous improvement while making a meaningful impact behind the scenes.