Delegated Credentialing Operations Lead

Tava Health; Colorado; Vor Ort; USD 70.000 - 100.000; Vollzeit

Benefits dieser Stelle

Competitive salary

Stock options

Medical and dental premiums

Mental health benefit

Monthly HSA contributions

Generous PTO & holidays

Parental leave

401(k)

Lunch program

Zusammenfassung

Tava Health is seeking a Delegated Credentialing Specialist to own day-to-day delegated credentialing across payer relationships and support NP and group practice credentialing. You will oversee audits, maintain audit-ready files, and partner with cross-functional teams to ensure accurate provider data.

The role requires CPCS certification and 2+ years in delegated credentialing, with strong attention to detail and excellent communication.

Qualifikationen

• 2–5 years of credentialing and enrollment experience, including at least 2 years specifically focused on delegated credentialing.
• Certified Provider Credentialing Specialist (CPCS) certification.
• Ability to manage multiple payer relationships with minimal oversight.
• Self-motivated team player who can multi-task and adjust priorities.
• High attention to detail, strong organization, and excellent documentation skills.

Aufgaben

• Oversee delegated credentialing activities for an assigned payer portfolio, including readiness reviews and audits.
• Monitor NCQA guidance and state regulations for compliance updates.
• Prepare for and facilitate credentialing audits; track corrective action plans.
• Maintain audit-ready credentialing records and reports.
• Coordinate provider data reconciliation with internal and delegated payer rosters.
• Lead NP and group practice credentialing activities; ensure timely status tracking.

Kenntnisse

Credentialing

Enrollment

CPCS Certification

Communication

Attention to detail

Tools

CAQH

NPDB

PECOS

Payer rostering tools

Credentialing software

Jobbeschreibung

Tava Health is seeking a Delegated Credentialing Specialist to own day-to-day delegated credentialing across payer relationships and support NP and group practice credentialing. You will oversee audits, maintain audit-ready files, and partner with cross-functional teams to ensure accurate provider data.

The role requires CPCS certification and 2+ years in delegated credentialing, with strong attention to detail and excellent communication.