Credentialing Manager

Talkspace

. Lead and manage a small group of Credentialing Interns, Associates, and Specialists, overseeing job assignments, performance reviews, and professional development while ensuring alignment with organizational goals.

Posted 10/7/2026full-timeRemote • New York • United StatesMid-LevelSenior💰 $80,000 - $90,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in credentialing operations, team leadership, and compliance management, with a strong focus on process optimization and stakeholder collaboration. Proficient in conducting audits and implementing best practices to ensure adherence to NCQA standards and improve operational efficiency.

Highest-signal resume keywords

Credentialing Operations ManagementTeam LeadershipNCQA Standards ComplianceCredentialing Verification Organization (CVO) ExperienceProcess Improvement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Credentialing OperationsAudit ConductingProcess ManagementCompliance MaintenanceData ReportingQuality ReviewProvider DocumentationWorkflow StreamliningPerformance ReviewTimesheet Approval

Soft Skills

Excellent CommunicationOrganizational SkillsProblem-SolvingCollaborationMentorship

Tools & Technologies

Credentialing SoftwareExcelWordGoogle SuiteMac Devices

Industry Keywords

CredentialingHealthcare OperationsComplianceDelegated CredentialingCross-Functional Team Management

About the role

Key responsibilities & impact

Lead and manage a small group of Credentialing Interns, Associates, and Specialists, overseeing job assignments, performance reviews, and professional development while ensuring alignment with organizational goals.
Approve timesheets, provide mentorship, and offer strategic support to optimize team performance and ensure operational success.
Streamline operational processes related to credentialing.
Prepare and present comprehensive credentialing packets for the Credentialing Committee, including flagged file reviews, logistics coordination, and credentialing KPI reporting.
Liaise with the Credentialing Verification Organization and Credentialing Supervisor to ensure timely completion, downloading, and uploading of files and accurate system updates.
Collaborate with credentialing stakeholders and the CVO to improve outreach, resolve inconsistencies, and facilitate weekly meetings.
Initiate and manage timely provider re-credentialing, including quality and complaint data review and provider documentation.
Identify non-engaging, zero-caseload providers and process administrative terminations when unresponsive.
Coordinate completion and scheduling of clinician re-credentialing cycles with the CVO.
Support delegated credentialing relationships with Enterprise clients and Account Management.
Provide regular network update reports and monthly roster reports to Enterprise clients.
Submit and track pre-delegation enrollment packets and outcomes.
Conduct regular CVO audits and quarterly internal Credentialing Program audits.
Provide data for Enterprise client audits.
Oversee review of credentialed licenses and support ongoing monitoring documentation and reporting.
Continuously review and refine credentialing workflows and implement best practices.
Perform other related duties as assigned.

Requirements

What you’ll need

Bachelor’s Degree required (Master’s Degree preferred) or 7+ years of professional experience in credentialing or a related field.
4+ years of professional experience in a credentialing, compliance, or healthcare operations role, with proven experience in team leadership and process management.
Strong background in managing credentialing operations, including experience working with Credentialing Verification Organizations (CVOs) and handling delegated credentialing agreements.
Familiar with NCQA standards and guidelines as well as policy and contract review to ensure compliance with said standards.
Demonstrated ability to manage cross-functional teams, lead projects, and streamline workflows to optimize efficiency.
Excellent communication, organizational, and problem-solving skills, with a strong focus on collaboration with both internal and external stakeholders.
Experience in conducting audits, maintaining compliance with regulatory standards, and implementing process improvements.
Familiarity with credentialing software and systems, as well as proficiency in reporting on credentialing metrics.
Proficient with Mac devices, Excel, Word, Google Suite (sheets, docs).

Benefits

Comp & perks

Comprehensive Medical, Dental and Vision plans
Pre-tax benefits: HSA/ FSA
401k Retirement Savings Program with matching up to 4%
Voluntary benefits including disability, basic life or pet insurance, etc.
Monthly Wellness Stipend to promote mental and physical self-care
Flexible PTO and Remote First Environment
Regular team events, including Wellness Workshops and Team Building Events
Free access to Talkspace products for you and one household member, as well as access to a friends and family discount!