Delegated 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 10/26/2026full-timeRemote • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in delegated credentialing activities, compliance monitoring, and audit preparation, with a strong focus on maintaining accurate provider records and managing payer relationships. Proficient in developing corrective action plans and facilitating Credentialing Committee operations.

Highest-signal resume keywords

Delegated Credentialing ExperienceCertified Provider Credentialing Specialist (CPCS)NCQA Compliance MonitoringCredentialing Software FamiliarityBehavioral Health Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Credentialing ActivitiesCompliance MonitoringAudit PreparationPrimary Source VerificationCorrective Action PlansProvider Data ManagementDocumentation SkillsPayer Relationship ManagementMulti-TaskingOperational Leadership

Soft Skills

Attention to DetailStrong OrganizationWritten CommunicationVerbal CommunicationSelf-Motivated Team Player

Tools & Technologies

CAQHNPDBPECOSCredentialing SoftwarePayer Rostering Tools

Certifications & Qualifications

Certified Provider Credentialing Specialist (CPCS)

Industry Keywords

HealthcareCredentialingEnrollmentAccreditationState Regulations

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 in accordance with NCQA and payer-specific requirements
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, including 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 and related processes and controls
Serve as operational lead for Credentialing Committee meetings, including preparation, execution, and follow-through
Maintain Credentialing Committee meeting minutes, training materials, committee records, and follow-up items
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 a 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
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
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
Personal DashPass subscription
Opportunity to make a meaningful impact at a high-growth, mission-driven company