Credentialing Specialist

Tava Health

. Oversee delegated credentialing activities for an assigned payer portfolio, including readiness reviews, ongoing compliance monitoring, recurring reporting, and annual audits .

Posted 9/29/2026full-timeRemote • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in delegated credentialing activities, including compliance monitoring, audit preparation, and provider data management. Proficient in maintaining accurate credentialing records and facilitating communication with payers and internal teams.

Highest-signal resume keywords

Delegated Credentialing ExperienceCertified Provider Credentialing Specialist (CPCS)Compliance MonitoringCredentialing Software FamiliarityAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CredentialingPrimary Source VerificationAudit PreparationCorrective Action PlansProvider Data Management

Soft Skills

Strong OrganizationExcellent Documentation SkillsOutstanding Written CommunicationOutstanding Verbal CommunicationSelf-Motivated Team Player

Tools & Technologies

CAQHNPDBPECOSCredentialing SoftwarePayer Rostering Tools

Certifications & Qualifications

Certified Provider Credentialing Specialist (CPCS)

Industry Keywords

HealthcareBehavioral HealthNCQA GuidanceState RegulationsAccreditation

About the role

Key responsibilities & impact

Oversee delegated credentialing activities for an assigned payer portfolio, including readiness reviews, ongoing compliance monitoring, recurring reporting, and annual audits
Monitor NCQA guidance, state regulations, and accreditation updates; assess operational impact and implement compliance changes
Prepare for and facilitate pre-delegation and annual credentialing audits; develop and track corrective action plans through resolution
Maintain complete, audit-ready credentialing records, including primary source verification, Credentialing Committee documentation, and adverse action logs
Prepare recurring deliverables for delegated partners and payers, such as provider rosters, audit materials, and credentialing activity reports
Monitor average time to credential, identify delays, manage follow-up, and escalate issues as needed
Partner with Enrollment, Partnerships, Revenue Cycle, Legal/Compliance, and other teams to maintain accurate provider data and reconcile internal records against delegated payer rosters
Serve as a point of contact for payer communications related to delegated credentialing activities, audits, provider records, and follow-up items
Support implementation of new delegated credentialing agreements, including processes and controls for contractual requirements
Lead Credentialing Committee meetings, including preparation, execution, minutes, training materials, records, and follow-up
Lead credentialing for Nurse Practitioners, including application review, primary source verification, committee readiness, payer submissions, follow-up, and status tracking
Support credentialing for group practice providers by coordinating documentation, resolving application gaps, monitoring timelines, and maintaining accurate provider records

Requirements

What you’ll need

2–5 years of credentialing and enrollment experience, including at least 2 years specifically focused on delegated credentialing
Certified Provider Credentialing Specialist (CPCS) certification through NAMSS
Ability to manage multiple payer relationships and responsibilities with minimal oversight
Self-motivated team player who thrives in multi-tasking environment and can adjust priorities
High attention to detail, strong organization, and excellent documentation skills
Outstanding written and verbal communication
High-growth/tech-enabled healthcare background preferred; behavioral health experience is a plus
Familiarity with CAQH, NPDB, PECOS, state licensing resources, credentialing software, and payer rostering tools
Candidates must have authorization to work in the U.S. without company sponsorship now or in the future

Benefits

Comp & perks

Competitive salary and stock options
Fully-covered medical and dental premiums for you and your family, plus voluntary insurance options
Free, generous Tava mental health benefit
Monthly HSA contributions for qualifying enrolled employees
Generous PTO and paid holidays
Paid parental leave
401(k) retirement plan
Weekly company-paid lunch via DoorDash and a personal DashPass subscription
Opportunity to make a meaningful impact at a high-growth, mission-driven company