Provider Credentialing and Practice Lead

Neko Health•New York, NY

1d•$137,000 - $167,000

About The Position

The Provider Credentialing and Practice Lead owns practice management for Neko Health's United States professional corporation. The role covers provider credentialing, SOP organization and maintenance, onboarding operationalization, and compliance assurance. Neko's tech-enabled clinical model requires the role to run these processes through systems and automation rather than manual tracking. The role maintains complete, current, source-verified credential files for every provider practicing under the PC, including licenses, certifications, permitted scope by state, malpractice coverage, and other expirable credentials. It operates the clear-to-practice gate, maintains provider readiness and SOP currency, coordinates onboarding from offer to start, and checks operations against standards set by the Head of Compliance. It also selects, configures, and owns tooling for provider data, expiry alerts, workflows, reporting, and SOP version control. As Neko expands into additional states, the role is responsible for making credentialing, onboarding, SOP maintenance, and compliance a scalable, evidence-backed managed process. The position also prepares the function for payer credentialing and provider enrollment if Neko US begins billing insurance.

Requirements

Experience streamlining clinical or healthcare operations in a tech-enabled environment, including rebuilding a manual or spreadsheet-run process as a system-driven workflow.
Experience in clinical operations with responsibility for building systems that ensure credentialing, compliance, and other processes are handled effectively.
Confidence configuring and administering operational tools, working with data and reporting, and using everyday automation.
Direct, hands-on experience with state medical board licensure and clinician credentialing processes, including primary source verification.
Experience maintaining a credentialing database or record system to an audit-ready standard.
Experience developing, organizing, and maintaining SOPs in a clinical or regulated operations setting.
Working knowledge of healthcare or clinical operations compliance standards and experience checking operations against them.
Precision and persistence in administrative work.

Nice To Haves

Experience in digital health, telehealth, or another tech-enabled care setting where clinical operations rely on product and tooling rather than paper.
Hands-on experience with credentialing or provider data platforms and operational workflow and tracking tools.
Experience working with product or engineering teams to specify operational tooling requirements.
Direct provider credentialing experience in a United States clinical setting, including multi-state credentialing.
Experience with credentialing in a newly opened market or startup clinical service where the process did not previously exist.
Experience building an SOP program from scratch in a growing or newly opened operation.

Responsibilities

Run credentialing intake for every new provider joining the PC, including applications, document collection, and primary source verification.
Verify state medical or nursing licenses, board certification, education and training, work history, and DEA registration where required by the provider's scope.
Operate the clear-to-practice gate and prevent providers from seeing members until their credential files are complete and verified.
Maintain each provider's permitted scope by state and flag requests to practice outside that scope to the Head of Compliance.
Own the expirables calendar for licenses, certifications, DEA registrations, malpractice coverage, and other time-limited credentials, using automated alerts.
Pursue renewals ahead of expiry and escalate renewals at risk.
Immediately remove clearance to practice when a credential lapses and notify the clinical rota owner and Head of Compliance the same day.
Run the re-verification cycle to keep credential files current.
Select, implement, and administer tooling for credentialing records, expiry tracking, onboarding workflows, and SOP version control.
Replace manual tracking with automated alerts, scheduled reporting, and system-driven handoffs; document remaining manual steps and plans to remove them.
Define credentialing and onboarding data structures so status can be reported directly from the system.
Work with IT and, where relevant, product and engineering, to integrate practice operations data with adjacent systems.
Create, index, version, review, update, and retire SOPs for US practice operations; flag processes without an SOP and keep procedures easy to find and use.
Turn each new provider's onboarding plan into a tracked sequence covering credentialing, system access, training, and clearance to start.
Own onboarding timelines from offer to start date, flag delays, and coordinate with Talent Acquisition, the People Team, and clinical operations.
Improve and automate onboarding tracking and reminders as volume grows.
Check US practice operations against standards set by the Head of Compliance, conduct periodic checks, report gaps, and escalate gaps requiring action beyond the role.
Support practice operations audits with evidence from SOPs, onboarding records, and credential files.
Maintain an accurate, audit-ready credentialing record system and produce credential files on request.
Report credentialing status, upcoming expiries, and blocked providers into the Medical Quality reporting cycle on a set cadence, using the system of record.
Prepare the function for payer credentialing and provider enrollment should Neko US move to billing insurance.