This job post is archived - the company is no longer hiring for this position.
Check out other job posts of this company here!ABOUT CERTIFY:
We are on a mission to change how the US healthcare industry deals with provider data. Our goal is to reduce the cost of healthcare by streamlining access to provider data and reducing administrative and regulatory burden on healthcare organizations.
Certify is building the infrastructure for provider-centric applications (network adequacy, accuracy, provider utilization, etc.) and aims to be the source of truth for provider data. The platform is API-first and UI-agnostic, automating licensing, enrollment, credentialing, and network monitoring with integrations into hundreds of primary sources.
Our team has experience building provider data systems at Oscar Health and is backed by top-tier venture firms. We value trust, transparency, accountability, and a meritocratic environment where every voice is heard.
ABOUT THE ROLE:
As Certify scales, we are adding rigor and structure to operational processes to drive high customer satisfaction and attractive unit economics. The Credentialing - Team Lead will lead a production-focused pod of Credentialing Specialists and Operations Analysts, overseeing day-to-day credentialing operations to ensure compliance with regulatory requirements and internal quality standards.
This is a fully remote role that requires strong leadership, direct client engagement, stakeholder management, and subject matter expertise in credentialing. The Team Lead will guide the team in meeting performance, quality, and compliance expectations.
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 strengthen credentialing knowledge and regulatory understanding.
- Oversee credentialing workflows to ensure compliance with NCQA guidelines, state regulatory requirements, and client-specific policies.
- Facilitate performance reviews, partner with Operations Management on ratings, and deliver performance conversations to team members.
- Host daily standups as needed and weekly performance reviews to align on priorities and identify improvement opportunities.
- Support onboarding and training of new hires and participate in hiring for new OAs joining the team.
- Regularly review team performance data and communicate insights upward, downward, and laterally to ensure alignment and accountability.
- Production Management:
- Responsible for meeting core performance metrics (speed, quality, efficiency) for supported clients and driving continuous improvements.
- Monitor contractual SLAs, turnaround times, and quality metrics; drive corrective actions to maintain compliance and efficiency.
- Partner with internal stakeholders to resolve escalations, streamline workflows, and improve outcomes.
- Oversee monthly monitoring and management of credentialing expirables.
- Maintain proactive communication with OAs to remove blockers and ensure productivity.
- Identify process gaps, implement documented improvements, and facilitate training sessions to ensure consistency.
- Create comprehensive SOPs and develop ad hoc reports to support operational needs.
What You'll Need
- Credentialing experience is a must-have.
- Minimum of 5+ years of professional experience, with at least 2 years in a team management role.
- Demonstrated ability to lead and manage teams of 5 or more members.
- Proven experience working effectively with cross-functional and global teams.
- Experience in client engagement and managing client relationships, including participation in client meetings and addressing escalations.
- A passion for continuous improvement and the ability to dive deep into processes and metrics.
- Hands-on, execution-focused approach in the short term and strategic thinking for long-term success.
- Strong organization, analytical, and problem-solving skills, with excellent written and verbal communication.
- Proven ability to manage multiple initiatives and prioritize critical objectives while overseeing daily production metrics.
Nice to Have:
- 2-3 years of experience in credentialing, provider enrollment, or healthcare compliance.
- Strong knowledge of NCQA guidelines and state/federal regulatory requirements related to credentialing.
- Proficiency in SQL, Excel Macros, and related data analysis tools.
$70,000 - $100,000 a year
Certify is committed to creating an inclusive workplace and is an equal opportunity employer welcoming applicants from diverse backgrounds.
How to Apply
To apply for this role, please use the online application link on the job posting page: https://jobs.lever.co/certifyos/ec2e027c-432a-4237-abb0-8fa5a4b91900/apply
Additional Notes
You may be redirected to Certify's Lever application form. If you need further assistance, visit the company careers page at https://jobs.lever.co/certifyos.