Payer Credentialing & Compliance Specialist

tavahealth; United States; Remote; USD 70,000 - 110,000; Full time

Benefits offered by this job

Stock options

Medical & dental coverage

Mental health benefit

HSA contributions

PTO & holidays

Parental leave

401(k)

Lunch benefit

Meaningful impact

Job summary

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

This role supports credentialing for Nurse Practitioners and group practices. Ideal candidates have CPCS certification, 2–5 years in credentialing, and a track record of managing multiple payer relationships with

Qualifications

• 2–5 years of credentialing and enrollment experience, including at least 2 years 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.
• Strong written and verbal communication; highly detail-oriented.

Responsibilities

• Oversee delegated credentialing activities for an assigned payer portfolio and manage audits.
• Monitor NCQA guidance and state regulations; implement compliance changes.
• Prepare for pre-delegation and annual audits and track corrective action plans.
• Maintain audit-ready credentialing records and committee documentation.
• Produce recurring deliverables for delegated partners and payers (rosters, reports).
• Monitor time to credential and address delays; escalate issues as needed.
• Collaborate with internal teams to reconcile provider data with delegated rosters.
• Serve as primary contact for payer communications on delegated credentialing.

Skills

Credentialing

Enrollment

Communication

Multi-tasking

Attention to detail

Education

CPCS certification

Tools

CAQH

NPDB

PECOS

Payer rostering tools

Credentialing software

Job description

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

This role supports credentialing for Nurse Practitioners and group practices. Ideal candidates have CPCS certification, 2–5 years in credentialing, and a track record of managing multiple payer relationships with