Delegated Credentialing Lead – Payer Compliance & NP/Group

Tava Health; North Carolina; On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Stock options

Medical & dental coverage

Mental health benefit

Monthly HSA contributions

PTO & holidays

Parental leave

401(k)

Lunch program

DashPass

Job summary

Tava Health is seeking a Delegated Credentialing Specialist to own day-to-day delegated credentialing across payer relationships. You will manage audits, provider data reconciliation, and action-plans while partnering with internal teams and delegated entities to support Nurse Practitioners and group practices.

Ideal candidates bring 2–5 years credentialing experience, CPCS certification, and strong attention to detail with excellent communication.

Qualifications

• 2–5 years of credentialing and enrollment experience, including at least 2 years focused on delegated credentialing.
• CPCS certification required.
• Ability to manage multiple payer relationships with minimal oversight.
• Self-motivated team player with strong organization and documentation skills.
• High-growth/tech-enabled healthcare background preferred; behavioral health experience a plus.
• Familiarity with CAQH, NPDB, PECOS, state licensing resources and payer rostering tools.

Responsibilities

• Oversee delegated credentialing activities for assigned payer portfolio, including readiness reviews and audits.
• Monitor NCQA guidance and state regulations, implementing necessary changes.
• Prepare for pre-delegation and annual credentialing audits and manage corrective actions.
• Maintain audit-ready credentialing records and related documentation.
• Prepare recurring deliverables for delegated partners and payers, such as rosters and reports.
• Monitor time to credential and escalate delays as needed.
• Collaborate with Enrollment, Partnerships, Revenue Cycle, Legal/Compliance and others to reconcile provider data.
• Lead Credentialing Committee meetings and maintain minutes and materials.
• Lead credentialing for Nurse Practitioners and group practice providers.

Skills

Credentialing

Enrollment

Multitasking

Attention to detail

Documentation

Communication

Stakeholder management

Education

CPCS certification

Tools

CAQH

NPDB

PECOS

Payer rostering tools

Credentialing software

Job description

Tava Health is seeking a Delegated Credentialing Specialist to own day-to-day delegated credentialing across payer relationships. You will manage audits, provider data reconciliation, and action-plans while partnering with internal teams and delegated entities to support Nurse Practitioners and group practices.

Ideal candidates bring 2–5 years credentialing experience, CPCS certification, and strong attention to detail with excellent communication.