Delegated Credentialing Specialist

About the Role:

• The Delegated Credentialing Specialist manages the full lifecycle of delegated credentialing agreements with health insurance payors.
• This role sits at the intersection of compliance, payor relationships, and operational execution.
• Critical to maintaining Grow Therapy's ability to contract and operate under delegated contracts at scale.

Responsibilities:

• Manage end-to-end delegated credentialing operations across an assigned portfolio of payors, including pre-delegation audits, ongoing compliance, quarterly reporting, and annual audits.
• Serve as the primary point of contact for delegated payor relationships, handling communications, data requests, and issue resolution with cross-functional teams.
• Prepare, coordinate, and execute both pre-delegation and annual credentialing audits, ensuring documentation, files, and processes meet NCQA and payor-specific standards.

Qualifications:

• You have 2-5 years of enrollment or credentialing experience, with at least 2 years of experience with delegated credentialing.
• You have working knowledge of NCQA credentialing standards and demonstrated experience preparing for and participating in delegated credentialing audits.
• You have the ability to manage multiple payor relationships and deadlines simultaneously without close supervision.