Supervise daily operations of the Medical Staff Office, ensuring efficient workflow and timely completion of credentialing activities.
Provide oversight for credentialing, privileging, and medical staff administrative processes in compliance with regulatory and accreditation standards.
Support medical staff meetings and committees, and maintain the integrity of the credentialing database.
Manage the standard credentialing review process for pharmacies.
Review exclusion lists to identify any excluded pharmacies.
Manage the development and maintenance of a credentialing database.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They have solutions such as Capital Rx and Judi® which consolidates all claim administration-related workflows in one scalable, secure platform.
Manage and supervise daily operational activities to ensure they align with organizational goals
Implement and enforce operational policies and procedures
Lead and motivate a team of operational staff
Better Health Group's mission is better health and their passion is helping others. They are a growing team that supports providers and payors, ensuring they have the necessary tools and resources to always deliver best-in-class healthcare experiences for patients.
Supervise, train, and support provider enrollment staff responsible for licensing, credentialing, and payer enrollment activities.
Monitor work quality and quantity, develop performance standards, and conduct audits on specific accounts or individual work.
Interpret complex healthcare regulations and draft departmental processes while managing employee relations, schedules, and performance reviews.
Ventra Health is a leading business solutions provider specializing in Revenue Cycle Management for facility-based physicians in fields like anesthesia and emergency medicine. The company partners with practices and hospitals to deliver transparent, data-driven financial solutions, fostering a culturally diverse and inclusive workplace where mutual respect is paramount.
Oversees the operations of the Care Coordination Team.
Manages daily operational workflows of Care Coordination teams to ensure practice readiness and service level performance.
Serves as the point of contact for operational escalations related to scheduling, access, onboarding and service recovery.
Teladoc Health is leading the next evolution of virtual care. They offer a high-performance culture where colleagues embrace challenges, drive transformative solutions, and create opportunities for growth.
Define and execute the long-term vision for credentialing and enrollment, transitioning from manual processes to a tech-enabled, scalable operation.
Oversee the end-to-end enrollment process for Medicare, Medicaid, and Commercial payers. Be the primary liaison for enterprise contract activations.
Lead the internal Credentialing Committee, presenting provider files and ensuring all primary source verifications (NPDB, OIG, SAM) are flawless.
Foodsmart is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Their platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. At Foodsmart, their mission is to make nutritious food accessible and affordable for everyone, regardless of economic status.
Creates trend and analysis reports and assists the manager with research and reconciliation.
Regularly tracks and monitors the productivity and accuracy of staff members.
Ensures accurate and efficient review and resolution of credit balances.
US Anesthesia Partners (USAP) is a physician-led, single-specialty anesthesia practice. They are committed to providing exceptional patient care, fostering a culture of collaboration, and advancing the field of anesthesia.
Responsible for credentialing and recredentialing of practitioner applicants.
Ensures the provider network meets regulatory criteria to minimize liability and maximize member safety.
Maintains confidentiality of practitioner information and performs detailed application reviews.
Curana Health is a national leader in value-based care, offering solutions to senior living communities and skilled nursing facilities. Founded in 2021, they serve 200,000+ seniors in 1,500+ communities across 32 states with a team of more than 1,000.
Oversee day‑to‑day clinical operations for UM, CM, and DM teams.
Ensure operational workflows meet productivity, quality, and turnaround time expectations.
Partner with the VP of Care Management on operational priorities and process improvements.
Personify Health created the first and only personalized health platform bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. It serves employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes.
Oversee daily operations and performance of Provider Enrollment Specialists.
Monitor team performance against standards and address gaps.
Provide coaching and development to strengthen team capability.
EnableComp provides specialty revenue cycle management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability. They are a multi-year recipient of the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years.
Manage the end-to-end process of licensing applications.
Coordinate the initial credentialing and re-credentialing processes for licensed providers.
Maintain accurate and up-to-date records of all licensing and credentialing activities.
InStride Health delivers specialty anxiety and OCD care. They combine research-backed clinical care and innovative technology to eliminate the major problems with care today, and become the nation’s most trusted provider of pediatric anxiety and OCD care.
Review and process applications in all DOHMH license applications and all relevant information.
Mange the day to day operations of the unit.
Supervise staff, including tracking and assigning tasks, to ensure productivity and effectiveness, conducting training and providing guidance
The NYC Department of Consumer and Worker Protection (DCWP) is the nation’s leading municipal enforcement agency charged with delivering economic justice. They license more than 45,000 businesses and provide essential services such as free tax preparation and financial counseling.
Supervises the coding function and corresponding staff.
Oversees reimbursement process.
Manages auditing and quality control and improvement initiatives.
Piedmont Healthcare aims to provide exceptional patient outcomes. They value diverse teams, a shared purpose, and flexibility, offering wellness programs and comprehensive benefits to support employees' needs and future plans.
Assist with patient care under the direction of physicians.
Prepare patients for office visits and procedures.
Preforms a variety of patient care activities , such as vaccine /medication administration , phlebotomy, and point of care testing.
Legacy Health is focused on providing good health for Our People, Our Patients, Our Communities, Our World. They are committed to fostering an inclusive environment where everyone can grow and succeed.
Build, monitor, and adjust daily and weekly provider schedules.
Act as the primary point of contact for provider schedule coordination.
Assign and manage the annual hospital call schedule, ensuring timely updates and distribution.
Cardiac Study Center aims to elevate patient health through compassionate, innovative cardiology care. They are a growing organization in the Pacific Northwest with a dedicated team at the forefront of cardiovascular medicine.
Serve as the primary subject matter expert for credentialing across state and federal contracts, executing workflows within government systems.
Lead the design, standardization, and continuous improvement of credentialing standard operating procedures to ensure compliance and efficiency.
Manage the end-to-end credentialing lifecycle including onboarding, renewals, and offboarding while ensuring audit-ready documentation and adherence to SLAs.
Nava is a consultancy and public benefit corporation focused on modernizing government services through improved user experiences and secure cloud infrastructure. The company bills for its time as a client services firm and has a culture centered on human-centered design, modern engineering, and delivering meaningful, impactful work connected to the public good.
Conduct weekly multidisciplinary rounds with Midwest and West Coast care teams, reviewing patient goals and providing clinical oversight.
Serve as the designated reviewer for patient escalations, applying clinical judgment to prioritize and direct cases to appropriate next steps.
Alternate monthly care delivery education sessions with co-Medical Lead, developing and facilitating case-based learning for various roles.
Waymark is a mission-driven team transforming care for people with Medicaid benefits by partnering with communities, delivering technology-enabled, human-centered support. We're designing tools and systems that bring care directly to those who need it most – removing barriers and reimagining what’s possible in Medicaid healthcare delivery.
Own the end-to-end credentialing and payer enrollment process for behavioral health providers across multiple states.
Manage internal credentialing onboarding for newly hired providers by collecting and validating required documentation.
Design and maintain credentialing and enrollment tracking systems to monitor application status, renewal timeliness, and enrollment milestones as the company scales.
Willow Health aims to significantly improve the mental health care experience by expanding affordable access to high-quality, evidence-based intensive behavioral health care. The co-founding team of Cityblock and Oscar alums has two decades of collective experience working in healthcare and healthcare tech, and they are backed by Andreessen Horowitz.
Execute the end-to-end staffing process from initial deal notification to confirmed provider assignment
Be the primary owner of the provider-to-assignment matching process
Communicate urgent provider status changes, such as resignation or leave notices, by escalating to the provider's Clinical Manager and HR
Parallel is the first tech-forward provider of care for learning and thinking differences across the United States. They believe learning differences are parallel ways of thinking that should be celebrated and are committed to fostering a diverse, accessible environment.
Oversee and prioritize work queues for overdue and expiring patient orders and test results.
Manage patient communications, and process Regional Medication Prior Authorizations.
Collaborate closely with clinic teams to ensure timely follow-up and seamless coordination of patient care tasks.
UnityPoint Health is committed to its team members and has been recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row. They champion a culture of belonging where everyone feels valued and respected and equip you with support and development opportunities.
Leads a team for virtual imaging and referral support.
Manages internal and external referrals for specialty and imaging orders.
Collaborates on quality and process improvement projects.
Included Health delivers integrated virtual care and navigation. The company is on a mission to raise the standard of healthcare for everyone and break down barriers to provide high-quality care for every person in every community.