Team Lead, Credentialing

Role Description

As Certify scales, we need to add rigor & structure to our operational processes to continue driving high customer satisfaction at increasingly attractive unit economics. We’re looking to hire an Operations Team Lead to lead a critical pod of our Credentialing team – someone who combines best-in-class people leadership with strong ownership and a relentless focus on speed & quality. This individual will oversee a production-focused pod made up of operations analysts (OAs).

The Credentialing, Team Lead will oversee day-to-day credentialing operations, ensuring compliance with regulatory requirements and internal quality standards. This role requires strong leadership, direct client engagement, and prior stakeholder management experience. The Team Lead will act as a subject matter expert, guiding the team in meeting performance, quality, and compliance expectations. This is a fully remote opportunity.

What You'll Do

• People Management & Team Leadership:
  • Lead and manage a team of Credentialing Specialists and Operational Analysts to ensure timely and accurate credentialing file processing.
  • Provide coaching, mentoring, and training to team members to strengthen credentialing knowledge and regulatory understanding.
  • Oversee credentialing workflows to ensure compliance with NCQA guidelines, state regulatory requirements, and client-specific policies.
  • Facilitate company performance reviews, and partner with Operations Management to determine performance ratings for the OAs on your team and deliver performance review conversations directly to your team members.
  • Host a daily standup with your team as needed to review the previous day’s performance and align on priorities for the day ahead.
  • Lead a weekly performance review to recap results from the prior week and identify opportunities for improvement.
  • Support the onboarding of new hires, providing education and guidance to team members during training.
  • Participate in the hiring process for new OAs joining your team.
  • Regularly review your team’s performance data on a daily and weekly basis, and communicate insights upward to management, downward to your team, and laterally to your peers.
• Production Management:
  • Meet core performance metrics for the subset of clients supported by your pod, focusing on speed, quality, and efficiency of file processing.
  • Monitor the contractual Service Level Agreement, turnaround times, and quality metrics; drive corrective actions to maintain compliance and efficiency.
  • Partner with internal stakeholders to resolve escalations, streamline workflows, and improve operational outcomes.
  • Oversee the monthly ongoing monitoring and management of credentialing expirables.
  • Maintain proactive communication with OAs to ensure they remain unblocked and productive.
  • Coordinate with Credentialing Management to identify the highest-priority files and ensure your team is fully equipped to process them.
  • Identify process gaps and implement documented improvements.
  • Facilitate team training sessions as needed to strengthen skills and ensure process consistency.
  • Create comprehensive SOPs and develop ad hoc reports to support operational needs.

Qualifications

• Minimum of 5+ years of overall professional experience, with at least 2 years in a team management role.
• Demonstrated ability to lead and manage a team of 5 or more members.
• Proven experience working effectively with cross-functional teams.
• Strong exposure to collaborating with global teams and stakeholders.
• Demonstrated success in client engagement and managing client relationships.
• A passion for driving continuous improvement in metrics week over week.
• Ability to be hands-on and execution-focused in the short term while also thinking strategically to drive long-term success.
• Proven excellence in organization and attention to detail.
• Proven ability to manage multiple initiatives simultaneously with a clear track record of prioritizing the most critical objectives.
• Strong organizational, analytical, and problem-solving skills.
• Excellent written and verbal communication skills.
• Proven ability to effectively manage in a production environment while overseeing and driving daily performance metrics.

Requirements

• Credentialing experience is a must have.

Nice to Have

• Minimum 2-3 years of experience in credentialing, provider enrollment, or healthcare setting and compliance.
• Strong knowledge of NCQA guidelines and state/federal regulatory requirements related to credentialing.
• Proficient in SQL, Excel Macros, and related data analysis tools.

Benefits

• 100% coverage of health, dental, and vision insurance premiums for employees.
• Unlimited PTO, with at least two weeks off each year to recharge for US-based team members.
• Health insurance, statutory leave benefits, and additional wellness (menstrual) leave for women in India.
• Commitment to building an inclusive environment where everyone feels valued and empowered.
• Pay transparency and an open culture where compensation conversations are encouraged and respected.