Delegated Credentialing Specialist - Payer Compliance & Audits

Tava Health; Ohio; Sur place; USD 65 000 - 90 000; Plein temps

Avantages offerts par ce poste

Competitive salary and stock options

Fully-covered medical and dental for你u

Free mental health benefit

Monthly HSA contributions

Generous PTO and paid holidays

Paid parental leave

401(k) retirement plan

Weekly company-paid lunch via DoorDash

Résumé du poste

Tava Health is seeking a Delegated Credentialing Specialist to own the day-to-day credentialing operations across payer relationships. You will manage audits, compliance reporting, and data reconciliation, while partnering with internal teams and delegated entities.

This role supports credentialing for Nurse Practitioners and group practices. Ideal candidates have 2–5 years in credentialing (2+ in delegated credentialing) and CPCS certification, with strong attention to detail and

Qualifications

• 2–5 years of credentialing and enrollment experience, including at least 2 years specifically focused on delegated credentialing.
• CPCS certification.
• 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.

Responsabilités

• Oversee delegated credentialing activities for an assigned payer portfolio, including readiness reviews and audits.
• Monitor NCQA guidance, state regulations, and accreditation updates; assess impact and implement changes.
• Prepare for and facilitate pre-delegation and annual credentialing audits; track corrective action plans.
• Maintain complete, audit-ready credentialing records and logs.
• Prepare recurring deliverables for delegated partners and payers (rosters, materials, reports).
• Lead Credentialing Committee meetings and maintain minutes and training materials.

Connaissances

Written and verbal communication

Attention to detail

Organization

Multi-tasking

Self-motivated

Team collaboration

Formation

Certified Provider Credentialing Specialist (CPCS)

Outils

CAQH

NPDB

PECOS

State licensing resources

Credentialing software

Payer rostering tools

Description du poste

Tava Health is seeking a Delegated Credentialing Specialist to own the day-to-day credentialing operations across payer relationships. You will manage audits, compliance reporting, and data reconciliation, while partnering with internal teams and delegated entities.

This role supports credentialing for Nurse Practitioners and group practices. Ideal candidates have 2–5 years in credentialing (2+ in delegated credentialing) and CPCS certification, with strong attention to detail and