Associate Credentialing Team Lead

BetterHelp

19d•$65,000 - $75,000•Remote

About The Position

The Associate Team Lead, Credentialing Committee is responsible for coordinating and supporting the organization's credentialing committee operations for flagged provider credentialing and recredentialing files requiring committee review, escalation, or additional investigation. This role coordinates the organization's scheduled Credentialing Committee meetings, typically held one to two times per month, as well as ad hoc and appeal committee meetings as needed, ensuring timely, accurate, and compliant review of complex provider cases across our national behavioral health network. The Associate Team Lead serves as a subject matter expert on NCQA credentialing standards, committee processes, and accreditation requirements while providing day-to-day guidance to credentialing specialists and supporting quality oversight, workflow coordination, and continuous process improvement for committee-bound cases.

Requirements

3+ years of experience in provider credentialing within a healthcare or behavioral health organization.
1+ years of experience leading credentialing committee meetings.
Experience supporting credentialing committee processes and provider file review.
Working knowledge of NCQA credentialing standards, accreditation requirements, and primary source verification.
Experience mentoring or providing guidance to team members in an operational environment.
Strong organizational, analytical, problem-solving, and communication skills.
Experience working with credentialing software and provider data management systems.

Nice To Haves

Experience in a national or multi-state provider organization.
Familiarity with delegated credentialing programs and payer credentialing requirements.
Experience supporting accreditation or regulatory audits.
Bachelor's degree or equivalent combination of education and relevant experience.

Responsibilities

Coordinate and facilitate scheduled Credentialing Committee meetings (typically one to two per month), as well as ad hoc and appeal committee meetings, including agenda development, case preparation, meeting logistics, and documentation.
Review flagged provider credentialing and recredentialing files to ensure completeness, accuracy, and readiness for committee review.
Ensure committee decisions are accurately documented and communicated to appropriate stakeholders.
Monitor timelines for flagged credentialing cases to ensure review within regulatory, accreditation, payer, and organizational requirements.
Serve as the primary escalation point for complex provider credentialing cases requiring committee review, additional investigation, or appeal.
Provide day-to-day guidance, coaching, and support to credentialing specialists and contractors.
Review credentialing files for accuracy, completeness, and compliance with internal policies, NCQA standards, and payer requirements.
Document committee processes through maintaining committee minutes and file documentation in accordance with credentialing policy.
Develop and maintain standardized committee workflows, checklists, and documentation processes.
Support onboarding, training, and ongoing development of credentialing team members.
Promote consistency and quality across credentialing committee operations.
Partner with Provider Operations, Compliance, Leadership, Legal, and the Credentialing Department to support credentialing committee activities.
Coordinate with credentialing verification vendors and internal departments to resolve outstanding file deficiencies.
Communicate committee outcomes and credentialing decisions to appropriate operational teams.
Support delegated credentialing activities and respond to internal and external audit requests.
Serve as the Credentialing Team spokesperson in Credentialing Committee meetings and the expert on credentialing processes in that setting; you’ll be the primary point of detail for the committee.
Track committee metrics, including credentialing volumes, turnaround times, pending cases, and committee outcomes.
Identify workflow inefficiencies and recommend process improvements to enhance operational effectiveness and scalability.
Maintain credentialing committee records and documentation in accordance with regulatory, accreditation, and organizational requirements.
Support readiness for NCQA, payer, and regulatory audits by ensuring complete and accurate committee documentation.