What to Expect When You Hire a Locum Tenens Agency (Step by Step)

The first time you called your agency, you probably got a recruiter who sounded like they’d done this a thousand times — because they had. Meanwhile, you were sitting there with a list of questions that felt too basic to ask and a vague sense that you were about to sign up for something with a lot of moving parts. You weren’t wrong.

The locum tenens placement process is genuinely straightforward once you’ve seen it laid out. The problem is nobody lays it out. Agencies have every incentive to make it feel effortless on their end, which means the complexity lands on you when something slips — a missing document, a reference who didn’t know they were being called, a credentialing file that stalled for two weeks over a form you could have submitted on day one.

Here’s the whole process, with realistic timelines and zero hand-waving.

The Short Version:

From first call to first shift is typically 60–90 days — 30 days for credentialing, another 30 days of lead time after placement confirmation. The process is manageable if you stay ahead of document requests and alert your references before they get cold calls.

Key Takeaways

• Credentialing averages 28–30 days; delays almost always trace back to missing documents or unreachable references
• Your agency handles licensing, travel, and malpractice logistics — but only if you respond promptly
• Credentialing approvals through agencies like LocumTenens.com stay valid for 3 years, so first-time friction is a one-time tax
• Assignment lengths range from a few shifts to several months; many run longer than 3 months

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Step 1: The Initial Call (Day 1)

You’ll speak with a recruiter — or submit a profile online and get called back fast. The recruiter’s job at this stage is to match your specialty, availability, and preferred geography against open assignments.

This conversation sets the whole engagement in motion. Be specific about what you want: geography, setting (hospital vs. clinic vs. ED), schedule flexibility, start date. Vague preferences produce mediocre matches.

Pro Tip:

Ask the recruiter directly which agency credentials to JCAHO standards and what their average credentialing turnaround is. A good agency should answer both questions without hesitation.

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Step 2: Document Collection (Days 2–7)

Once you’ve identified assignments worth pursuing, the agency opens a credentialing file. Here’s what you’ll typically need to provide:

• Current CV
• Signed application with release authorization
• Professional headshot (yes, this matters — it goes on your badge, CV, and references)
• State license(s) — or confirmation that you need assistance obtaining one
• DEA certificate
• Board certification documentation
• Life support certifications (BLS, ACLS, etc.)
• Malpractice history documentation
• Education and training records
• Full employment history
• 3–5 professional references

Nobody tells you this, but the headshot requirement catches people off guard every time. Get a clean, professional photo ready before you start the process.

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Step 3: Agency Credentialing (Days 7–37)

This is the longest phase — and the one most likely to slip. The agency’s credentialing team runs primary source verification on your identity, education, training, licensure, DEA registration, board certifications, malpractice history, and work history. They’re credentialing to JCAHO standards before they’ll submit you to a facility.

Average turnaround: 28–30 days from application to approval.

Reality Check:

That 28–30 day window assumes everything goes smoothly. The two most common delay triggers are gaps in employment history documentation and references who don’t respond quickly because they weren’t warned. Pre-alert every reference before you list them. One email or text buys you days.

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Step 4: State Licensing (Parallel with Credentialing)

If you don’t already hold a license in the assignment state, the agency assists with the application. This runs parallel to credentialing but can extend your timeline if you’re starting from scratch in a new state. Requirements vary significantly by state.

The agency handles the logistics, but you’ll need to respond to requests quickly. Licensing offices don’t operate on your timeline.

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Step 5: Facility Submission and Privileging

Once agency credentialing is complete, your file goes to the facility for their own credentialing and privileging process. The agency shares documents; the facility runs its internal review. Legal agreements between the facility and agency are executed at this stage — review turnaround varies by organization.

This step is largely out of your hands, but your agency’s relationship with the facility matters here. Strong agency-facility partnerships can accelerate this considerably.

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Step 6: Confirmation Letter

When placement is confirmed, you receive a confirmation letter specifying:

• Assignment dates
• Location and facility
• Your compensation rate
• Schedule details

Read this carefully. This is the document everything flows from.

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Step 7: Travel and Onboarding Logistics (Days 30–60 Post-Confirmation)

Expect roughly 30 days between confirmation and assignment start for travel coordination. Your agency covers flights, car rentals, lodging, and tolls — but the arrangements need to be made, and a 24/7 travel team (offered by agencies like Hayes Locums) makes a real difference when you’re navigating last-minute changes.

Onboarding varies by facility but typically includes:

• Facility orientation and physical tour
• EMR/EHR system training
• Scheduling and duty delineation
• Policy and compliance walkthroughs

Pro Tip:

Ask upfront about the facility’s EHR system. If you’re unfamiliar with it, request training materials before day one. Walking in cold to an Epic or Cerner environment you’ve never used wastes half your first shift.

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Timeline Summary

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What You Actually Need to Do

I’ll be honest: most of the process is the agency’s job. Recruiting, licensing, credentialing coordination, travel — that’s what you’re paying for when you work through a reputable agency. Your job is to be fast and thorough on your end.

The providers who have frustrating first placements are almost always the ones who submitted incomplete document packages, listed references without warning them, or went quiet for a week during a credentialing request. The ones who have smooth placements treated their agency like a business partner with a hard deadline.

Once your credentialing is on file — at an agency like LocumTenens.com, it stays valid for 3 years — repeat placements move dramatically faster. The 60–90 day first-time investment buys you a much simpler process for every subsequent assignment.

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Practical Bottom Line

Step 1: Call or apply online. Have your CV ready before the conversation ends.

Step 2: Pull your document package together immediately — headshot included. Don’t wait for requests.

Step 3: Alert your references the same day you list them.

Step 4: Respond to every credentialing request within 24 hours. Delays compound.

Step 5: Use the 30-day post-confirmation window to research the facility’s EHR and prepare for onboarding.

For a full orientation to how locum tenens agencies work — including how to evaluate them and what to look for in a staffing partner — see The Complete Guide to Locum Tenens Agencies.