Credentialing Specialist

Responsibilities Provide day-to-day guidance, training, and support to credentialing associates Design, document, and implement scalable credentialing workflows and standard operating procedures (SOPs). Identify and troubleshoot inefficiencies in credentialing and recredentialing processes. Collaborate cross-functionally to ensure credentialing processes integrate smoothly with clinical, compliance, and billing teams. Manage relationship with CVO (Credentialing Verification Organization), Verifiable Maintain accurate and up-to-date provider information in internal databases and Verifiable Track application statuses, credentialing deadlines, and recredentialing timelines to ensure timely completion. Analyze and update processes to improve timelines Liaise with CVO to resolve any issues or delays in the credentialing process. Develop and maintain dashboards, reports, and trackers related to provider credentialing and compliance. Analyze data to identify trends, delays, or potential risks in credentialing timelines. Provide regular updates to leadership on key metrics and process improvements. Requirements 3+ years of experience in healthcare credentialing, operations, or administrative support in a payer or provider setting. 1+ years experience supervising credentialing associates Operational leadership and accountability Strong understanding of NCQA credentialing requirements and best practices. Proficiency with Microsoft Excel/Google Sheets and experience with CRM or credentialing software (e.g., CAQH, Verifable). Excellent organizational and communication skills, with the ability to manage multiple tasks and deadlines. Experience in behavioral health or mental health provider credentialing. Ability to work in the US, to travel to our San Jose, California offices up to three times per year and to an additional company offsite. Certifications & Qualifications NCQA credentialing requirements #J-18808-Ljbffr