Credentialing - Team Lead

Certify•New York, NY

10d•$70,000 - $100,000•Remote

About The Position

As Certify scales, we need to add rigor & structure to our operational processes to continue driving high customer satisfaction at increasingly attractive unit economics. Weâre looking to hire an Operations Team Lead to lead a critical pod of our Credentialing team â someone who combines best-in-class people leadership with strong ownership and a relentless focus on speed & quality. This individual will oversee a production-focused pod made up of operations analysts (OAs). The Credentialing, Team Lead will oversee 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 Lead will act as a subject matter expert, guiding the team in meeting performance, quality, and compliance expectations. This is a fully remote opportunity.

Requirements

Minimum of 5+ years of overall professional experience, with at least 2 years in a team management role.
Demonstrated ability to lead and manage a team of 5 or more members.
Proven experience working effectively with cross-functional teams.
Strong exposure to collaborating with global teams and stakeholders.
Demonstrated success in client engagement and managing client relationships.
A passion for driving continuous 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 outcomes.
Ability to be hands-on and execution-focused in the short term while also thinking strategically to drive long-term success.
Proven excellence 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.

Nice To Haves

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

Responsibilities

Lead and manage a team of Credentialing Specialists and Operational Analysts to ensure timely and accurate credentialing file processing.
Provide coaching, mentoring, and training to team members to strengthen credentialing knowledge and regulatory understanding.
Oversee 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 dayâs performance and align on priorities for the day ahead. Additionally, you will lead a weekly performance review to recap results from the prior week and identify opportunities for improvement.
Other focus areas will include supporting the onboarding 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 teamâs performance data on a daily and weekly basis, and communicate insights upward to management, downward to your team, and laterally to your peers to ensure alignment and accountability across all levels.
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 outcomes.
Oversee the monthly ongoing monitoring and management of credentialing expirables.
Maintain proactive communication with OAs to ensure they remain unblocked and productive. In addition, coordinate with Credentialing Management to identify the highest-priority 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 develop ad hoc reports to support operational needs.
Serve as the primary point of contact for client engagement, including participating in client meetings, addressing escalations, and ensuring client satisfaction.
Proven ability to effectively manage in a production environment while overseeing and driving daily performance metrics.