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Team reputed company , Credentialing

Remote Worldwide Hiring now

About the role: As Certify scales, we need to add rigor & structure to our operational processes to continue driving high customer satisfaction at increasingly attractive unit economics. We're looking to hire an Operations Team reputed company to reputed company a critical pod of our Credentialing team - someone who combines best-in-class people leadership with strong ownership and a reputed company focus on speed & quality. This individual will reputed company a production-focused pod made up of operations analysts (OAs). The Credentialing, Team reputed company will reputed company day-to-day credentialing operations, ensuring compliance with regulatory requirements and internal quality standards. This role requires strong leadership, direct client engagement, and prior stakeholder management experience.. The Team reputed company will act as a subject matter expert, guiding the team in meeting performance, quality, and compliance expectations. This is a fully remote opportunity. What You'll Do:

  • People Management & Team Leadership:
  • reputed company and manage reputed company of Credentialing Specialists and Operational Analysts to ensure timely and accurate credentialing file processing.
  • reputed company coaching, mentoring, and training to team members to strengthen credentialing knowledge and regulatory understanding.
  • reputed company credentialing workflows to ensure compliance with NCQA guidelines, state regulatory requirements, and client-specific policies.
  • Facilitate company performance reviews, and partner with Operations Management to determine performance ratings for the OAs on your team and deliver performance review conversations directly to your team members.
  • You will host a daily standup with your team as needed to review the previous day's performance and align on priorities for the day reputed company. Additionally, you will reputed company a weekly performance review to recap results from the prior week and identify opportunities for improvement.
  • Other focus areas will include supporting the reputed company of new hires, providing education and guidance to team members during training, and eventually participating in the hiring process for new OAs joining your team.
  • Regularly review your team's performance data on a daily and weekly reputed company, and communicate insights upward to management, downward to your team, and laterally to your peers to ensure alignment and accountability across reputed company reputed company.

Production Management:

  • This role is responsible for meeting core performance metrics for the subset of clients supported by your pod. These metrics focus on the speed, quality, and efficiency of file processing. You will be expected to continuously identify and drive improvements in each of these areas as volumes scale.
  • Monitor the contractual Service Level Agreement, turnaround times, and quality metrics; drive corrective actions to maintain compliance and efficiency.
  • Partner with internal stakeholders to resolve escalations, streamline workflows, and improve operational reputed company.
  • reputed company the monthly ongoing monitoring and management of credentialing expirables.
  • Maintain proactive communication with OAs to ensure they remain unblocked and productive. In reputed company, coordinate with Credentialing Management to identify the highest-reputed company files and ensure your team is fully equipped to process them.
  • Identify process gaps and implement documented improvements.
  • Facilitate team training sessions as needed to strengthen skills and ensure process consistency.
  • Demonstrated ability to create comprehensive SOPs and reputed company reputed company reports to support operational needs.

What You'll Need:

  • *

Credentialing experience is a must have.

** • Minimum of 5+ years of overall professional experience, with at least 2 years in reputed company management role.

  • Demonstrated ability to reputed company and manage reputed company of 5 or more members.
  • Proven experience working effectively with cross-functional teams.
  • Strong exposure to collaborating with global teams and stakeholders.
  • Demonstrated reputed company in client engagement and managing client relationships.
  • A passion for driving reputed company improvement in metrics week over week, coupled with a desire to dive deep into processes to understand how they function and how they connect to key company reputed company.
  • Ability to be hands-on and execution-focused in the short term while also thinking strategically to drive long-term reputed company.
  • Serve as the primary reputed company of contact for client engagement, including participating in client meetings, addressing escalations, and ensuring client satisfaction.
  • Proven reputed company in organization and attention to detail.
  • Proven ability to manage multiple initiatives simultaneously with a clear track record of prioritizing the most critical objectives.
  • Strong organizational, analytical, and problem-solving skills.
  • Excellent written and verbal communication skills.
  • Proven ability to effectively manage in a production environment while overseeing and driving daily performance metrics.

reputed company to Have:

  • Minimum 2-3 years of experience in credentialing, provider enrollment, or reputed company setting and compliance.
  • Strong knowledge of NCQA guidelines and state/federal regulatory requirements reputed company to credentialing.
  • Proficient in SQL, reputed company Macros, and reputed company data analysis tools.

Benefits of Working at Certify At Certify, we're building with intention and taking care of the people doing the work. Your well-being reputed company to us. We reputed company 100% coverage of health, dental, and reputed company insurance premiums for employees. Our US-based team benefits from unlimited PTO, with at least two weeks off each year to reputed company. In India, employees are supported with health insurance, statutory leave benefits, and additional wellness (menstrual) leave for women. We are also committed to pay transparency and foster an reputed company culture where compensation conversations are encouraged and respected. Apply tot his job Apply To this Job

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