Credentialing Team Lead

ComplianceComplianceFull TimeRemoteLeadTeam 1-10Since 2013H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

4 days ago

Salary

$55K - $75K / year

Seniority

Lead

No structured requirement data.

Job Description

Credentialing Team Lead

BetterHelp

Role Description As the Credentialing Team Lead at BetterHelp, you’ll join a diverse team of licensed clinicians, engineers, product pros, creatives, marketers, and business leaders who share a passion for expanding access to therapy. This role will be responsible for supervising and improving all Credentialing and Recredentialing Workflows and Team Members. - Maintain the full cycle provider credentialing and recredentialing processes. - Emphasize building and improving operational processes. - Improve team turnaround times and develop credentialing workflows. - Supervise a team of credentialing associates. What will you do? - Process Development & Optimization: - Provide day-to-day guidance, training, and support to credentialing associates. - Design, document, and implement scalable credentialing workflows and standard operating procedures (SOPs). - Identify and troubleshoot inefficiencies in credentialing and recredentialing processes. - Collaborate cross-functionally to ensure credentialing processes integrate smoothly with clinical, compliance, and billing teams. - Manage relationship with CVO (Credentialing Verification Organization), Verifiable. - Credentialing Operations & Maintenance: - Maintain accurate and up-to-date provider information in internal databases and Verifiable. - Track application statuses, credentialing deadlines, and recredentialing timelines to ensure timely completion. - Analyze and update processes to improve timelines. - Liaise with CVO to resolve any issues or delays in the credentialing process. - Reporting & Data Management: - Develop and maintain dashboards, reports, and trackers related to provider credentialing and compliance. - Analyze data to identify trends, delays, or potential risks in credentialing timelines. - Provide regular updates to leadership on key metrics and process improvements. What will you NOT do? - You will NOT worry about "runway", "cash left", or "how much time we have until the next round". - You will NOT be confined to your "job". - You will NOT be bogged down by office politics, ego, or bad attitude. - You will NOT get yourself burned out. We believe in maintaining a sustainable work/life balance. Requirements - 3+ years of experience in healthcare credentialing, operations, or administrative support in a payer or provider setting. - 1+ years experience supervising credentialing associates. - Operational leadership and accountability. - Strong understanding of NCQA credentialing requirements and best practices. - Proficiency with Microsoft Excel/Google Sheets and experience with CRM or credentialing software (e.g., CAQH, Verifiable). - Excellent organizational and communication skills, with the ability to manage multiple tasks and deadlines. - Experience in behavioral health or mental health provider credentialing. - Ability to work in the US, travel to our San Jose, California offices up to three times per year, and attend an additional company offsite. Benefits - Remote work with regular in-person bonding experiences sponsored by the company. - Competitive compensation. - Holistic perks program (including free therapy, employee wellness, and more). - Excellent health, dental, and vision coverage. - 401k benefits with employer matching contribution. - The chance to build something that changes lives – and that people love. - Any piece of hardware or software that will make you happy and productive. - An awesome community of co-workers.

Related Categories

Related Job Pages

More Compliance Jobs

Monroe Group Ltd. logo

Regional Compliance Specialist

Monroe Group Ltd.

Monroe Group is a Denver-based company specializing in affordable family, senior and disabled housing property mgt.

Compliance4 days ago
Full TimeRemoteTeam 201-500H1B No Sponsor

• The Regional Compliance Specialist is responsible for all aspects of Project Based Section 8, Low Income Housing Tax Credit, HOME and Bond compliance for Monroe Group’s growing portfolio. • Evaluate agency requirements and implement compliance procedures for development for all properties • Monitor state agencies to stay updated on new policies, procedures and compliance related forms. • Ensure all properties employ the correct leasing forms and procedures (including tenant screening), comply with applicable leasing laws. • Coordinate documentation and attendance for Management Reviews with Community Manager, Regional PMs and State Compliance Agency prior to on-site reviews. • Report all non-compliant properties and work with Director of Compliance to develop action plans for non-compliant properties.

Colorado
$75K - $80K / year
argenx logo

Associate Director, Ethics & Compliance – Risk Assessment and Monitoring

argenx

United in our commitment to improve the lives of patients

Compliance4 days ago
Full TimeRemoteTeam 1,001-5,000Since 2008H1B Sponsor

• Design and implement a next-generation Risk Assessment and Mitigation Plan (RAMP) framework using AI, machine learning, behavioral patterns, and data analytics to proactively identify emerging compliance risks • Collect and analyze data to identify emerging global risks, control gaps, fraud, or non-compliance, and deliver clear reports and dashboards to inform strategic risk decisions • Developing, implementing, and enhancing a dynamic monitoring framework • Ensure timely, high-quality monitoring reports with executive summaries, root cause analysis, and clear recommendations • Maximize collaboration with external partners to oversee the execution of monitoring activities • Drive strategy and plan for live monitoring activities • Implement robust processes to ensure the quality, integrity, and traceability of data used in risk assessments • Serve as the primary compliance contact for Internal Audit • Oversee third-party risk management activities • Support gap assessment efforts

Massachusetts
$172K - $236.5K / year
Full TimeRemoteTeam 1,001-5,000Since 1964H1B No Sponsor

Role Description At UniSystems, we are working towards turning digital visions into reality. We are continuously growing and we are looking for a Data Protection Compliance Expert to join our UniQue team. What will you be doing in this role: - Ensure compliance of IT operations with data privacy and data protection standards, laws and regulations. - Assist in designing, implementing, auditing and compliance testing activities in order to ensure data and privacy compliance. - Advise on data protection matters, in particular in the context of personal data processing. - Conduct privacy impact assessments. - Write and/or review records of processing activity on personal data for data controllers and privacy statements. - Develop, maintain, communicate and train upon the data privacy policies and procedures. - Provide legal advice and guidance on data privacy and data protection standards, laws and regulations. - Enforce and advocate organization’s data privacy and protection program. - Ensure that data owners, holders, controllers, processors, subjects, internal or external partners and entities are informed about their data protection rights, obligations and responsibilities. - Monitor audits and data protection related training activities. - Develop and propose staff awareness training to achieve compliance and foster a culture of data protection within the organization. Qualifications - A Master's degree in a relevant field and at least 5 years of IT relevant professional experience and 4 years in a similar position. - At least 5 years of personal data protection compliance experience in an ICT, EU institutional, public-sector or similarly technology-heavy environment, including hands-on work with real systems, services or processing activities. - At least 3 years of hands-on experience preparing, updating or reviewing RoPAs, DPIAs, DPA, TIA or related personal data protection documentation for real systems or processing activities, including data mapping and obtaining or validating input from system owners, technical owners, architects, operations, cybersecurity/SOC teams or vendors. - At least 2 years of experience analysing and documenting technical arrangements relevant to personal data protection, including access rights, privileged access, logs or SIEM/log exports, retention, hosting, data flows, support access, transfers, processors or subprocessors. - Excellent knowledge and understanding of the EU data protection legislation and regulations. - Excellent knowledge of data protection standards, policies, methodologies and frameworks. - Excellent knowledge and understanding of legal, regulatory and legislative compliance requirements, recommendations and best practices. - Excellent knowledge and understanding of IT Operations and IT Services delivery. - Practical experience with privacy impact assessment standards, methodologies and frameworks. - Practical experience writing and reviewing records of processing activity on personal data for data controllers and privacy statements. - Required certificates, at least 3 of the among: CISA (Certified Information Systems Auditor), CISM (Certified Information Security Manager), GSNA (GIAC Certified Systems and Network Auditor), GCCC (GIAC Certified Critical Controls), ISO 27001 Lead implementer, ISO 27001 Lead Auditor, ISO 27005 Risk Manager, CAP ((ISC)2 Certified Authorization Professional), CRISC (ISACA Certified in Risk and Information Systems Control), CISSP-ISSMP ((ISC)2 Certified Information Systems Security Management Professional), GIAC Certified ISO-27000 Specialist or equivalent certification recognized internationally. - Excellent command of spoken and written English (C1). Company Description At Uni Systems, we are providing equal employment opportunities and banning any form of discrimination on grounds of gender, religion, race, color, nationality, disability, social class, political beliefs, age, marital status, sexual orientation or any other characteristics. Take a look at our Diversity, Equality & Inclusion Policy for more information.

Poland
Full TimeRemoteTeam 1,001-5,000Since 1964H1B No Sponsor

• Ensure compliance of IT operations with data privacy and data protection standards, laws and regulations. • Assist in designing, implementing, auditing and compliance testing activities in order to Ensure data and privacy compliance. • Advise on data protection matters, in particular in the context of personal data processing. • Conduct privacy impact assessments. • Write and/or review records of processing activity on personal data for data controllers and privacy statements. • Develop, maintain, communicate and train upon the data privacy policies and procedures. • Provide legal advice and guidance on data privacy and data protection standards, laws and regulations. • Enforce and advocate organization’s data privacy and protection program. • Ensure that data owners, holders, controllers, processors, subjects, internal or external partners and entities are informed about their data protection rights, obligations and responsibilities. • Monitor audits and data protection related training activities. • Develop and propose staff awareness training to achieve compliance and foster a culture of data protection within the organization.

Poland