Credentialing Program Lead

Job Summary

Leading and optimizing the credentialing program for a growing provider network, the Credentialing Program Lead will manage initial credentialing, recredentialing, and ongoing monitoring processes while ensuring compliance with organizational policies and regulatory standards in a fully remote role.

Key responsibilities

• Oversee the execution and continuous improvement of the credentialing program, including documentation standards and exception handling
• Administer the Credentialing Committee's operations, including meeting facilitation and decision tracking
• Enhance policies, workflows, and governance processes to align with regulatory and accreditation requirements

Required qualifications

• 5+ years of experience in credentialing programs, provider operations, or related healthcare functions
• Experience with Credentialing Committee activities and regulatory compliance
• Knowledge of credentialing standards, including NCQA and URAC
• Familiarity with credentialing software and provider data management systems
• Strong program management and analytical skills