Credentialing - Team Lead

Minimum of 5+ years of overall professional experience. 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. Passion for driving continuous improvement in metrics. Ability to be hands-on and execution-focused while thinking strategically. Serve as the primary point of contact for client engagement. Proven excellence in organization and attention to detail. Proven ability to manage multiple initiatives simultaneously. Strong organizational, analytical, and problem-solving skills. Excellent written and verbal communication skills. Proven ability to effectively manage in a production environment. Minimum 2-3 years of experience in credentialing, provider enrollment, or healthcare setting and compliance (Nice to Have). Strong knowledge of NCQA guidelines and state/federal regulatory requirements (Nice to Have). Proficient in SQL, Excel Macros, and related data analysis tools (Nice to Have).

Lead and manage a team of Credentialing Specialists and Operational Analysts. Provide coaching, mentoring, and training to team members. Oversee credentialing workflows to ensure compliance with guidelines and policies. Facilitate company performance reviews and deliver performance review conversations. Host daily standups and weekly performance reviews. Support the onboarding of new hires and participate in hiring processes. Review team performance data and communicate insights. Meet core performance metrics for client-supported pods focusing on speed, quality, and efficiency. Monitor contractual Service Level Agreement, turnaround times, and quality metrics. Partner with internal stakeholders to resolve escalations and streamline workflows. Oversee monthly ongoing monitoring of credentialing expirables. Maintain proactive communication with OAs to ensure productivity. Identify process gaps and implement documented improvements. Facilitate team training sessions. Create comprehensive SOPs and develop ad hoc reports.