Facility: OrthoIndy Northwest, Indianapolis, IN  
Department: OrthoIndy Enterprises Credentialing 
Shift Details: Full-time exempt

Great people are the backbone to great care and patient satisfaction. In return, we’ll have your back—offering our employees a supportive team environment, great benefits, a true work/life balance, and the opportunity to positively impact the quality of life for our patients. Join TEAM OI.

General Statement of Duties:

The Credentialing Manager and Compliance Officer is responsible for providing strategic leadership and oversight of the organization’s compliance program and credentialing operations across OrthoIndiana (the newly formed organization comprised of Fort Wayne Orthopedics, OrthoIndy, and Tri-State Orthopaedics). This role ensures adherence to federal and state regulatory requirements, accreditation standards, and organizational policies, while leading audit, risk management, and provider credentialing functions to support safe, compliant, and efficient operations. Serving as the designated Compliance Officer, this position will partner with executive leadership, clinical teams, and administrative departments and committees to identify and mitigate regulatory risk, maintain continuous survey readiness, and ensure providers meet all licensure, enrollment, and privileging requirements. The Credentialing Manager and Compliance Officer also promotes a culture of accountability and ethical practice, supports governance through committee leadership and Board reporting, and drives continuous improvement in compliance and credentialing processes across the organization.

Essential Duties:

1. Leads and oversees the organization’s compliance program for OrthoIndy, ensuring alignment with Office of Inspector General (OIG) guidelines and federal and state regulatory requirements, with systems in place to prevent, detect, and correct noncompliance.
2. Provides strategic direction for regulatory compliance, interpreting and operationalizing requirements related to CMS Conditions of Participation, Stark Law, Anti-Kickback Statute, HIPAA, and other healthcare regulations across the organization. Utilizes legal resources for guidance where needed and for BAA implementation.
   
3. Directs enterprise-wide compliance risk assessments and work planning, establishing a risk-based compliance strategy that prioritizes high-risk areas, regulatory changes, and enforcement trends impacting operations and provider services.
   
4. Oversees audit, monitoring, and investigation functions, including internal audits, credentialing reviews, and compliance investigations, ensuring objective evaluations, timely resolution, and effective corrective action planning.
   
5. Leads all credentialing and provider enrollment operations, ensuring physicians and non-physician practitioners meet CMS, state licensure, payer, and accrediting body requirements, with processes that support accuracy, timeliness, and regulatory compliance.
   
6. Establishes and maintains credentialing and privileging standards, ensuring documentation is complete, accurate, and audit-ready, and that credentialing practices align with regulatory requirements and organizational expectations for provider oversight.
   
7. Develops and promotes a culture of compliance through initial and annual education and training. Implements or maintains organization-wide and targeted programs based on regulatory updates, audit findings, and identified risk areas.
   
8. Serves as the designated Compliance Officer, providing leadership to the Compliance Committee and Credentialing/Medical Staff Committees, and delivering regular reporting to executive leadership and the Board on compliance program effectiveness, risks, and corrective actions.
   
9. Provides leadership, accountability, and cross-functional collaboration, partnering with HR, legal, operations, and clinical leadership to enforce compliance standards, strengthen internal controls, support regulatory inquiries, and drive continuous improvement across the organization.

Requirements:

• Bachelor's degree (B.A./B.S.) or equivalent (Preferred), Specialty training beyond high school (e.g., Vocational School) (Required)
• 10-15 years of related experience required, Progressive experience in healthcare compliance, provider credentialing, or related healthcare operations required in lieu of Bachelor's degree.
• Qualified applicants of the OrthoIndiana divisional practices will be given preference and are encouraged to apply

OrthoIndy is an Equal Opportunity Employer