Credentialing Program Lead (Healthcare)

TL;DR

Credentialing Program Lead (Healthcare): Leading and optimizing the credentialing program for a growing provider network with an accent on policy development, audit readiness, and cross-functional governance. Focus on translating regulatory requirements into scalable workflows and driving operational excellence across provider operations, compliance, and clinical quality.

Location: Remote within the USA (excluding Hawaii)

Compensation: $91,163 – $143,000 USD (based on location zone)

Company

hirify.global is a global mental health benefits platform providing employers with a comprehensive solution for employee well-being, backed by top-tier investors and recognized for innovation in the digital health space.

What you will do

• Lead and optimize the end-to-end credentialing and recredentialing program, including monitoring and documentation standards.
• Administer the Credentialing Committee, managing agendas, primary source verification, and meeting facilitation.
• Ensure all activities align with NCQA, URAC, and state regulatory requirements.
• Refine program goals, SLAs, and metrics to monitor operational performance and audit readiness.
• Collaborate across Provider Operations, Compliance, Legal, and Clinical Quality to mitigate risk and drive accountability.
• Identify and implement process improvements and tooling to support a scalable provider network.

Requirements

• 5+ years of experience in credentialing programs, provider operations, or healthcare operations.
• Deep knowledge of credentialing standards including NCQA, URAC, and state regulatory requirements.
• Proven experience managing Credentialing Committee activities and audit readiness.
• Proficiency with credentialing software, provider data management, and primary source verification tools.
• Must be authorized to work in the USA without employer sponsorship.
• Strong program management and cross-functional communication skills.

Nice to have

• Experience in digital health, telehealth, or behavioral health environments.
• CPCS or CPMSM certification.

Culture & Benefits

• Comprehensive health coverage including Medical, Dental, Vision, and Disability insurance.
• Financial wellness support via 401k and financial planning benefits.
• Generous time off policy and company-wide collective pause days.
• Professional development stipend and annual wellness stipend.
• Family support benefits including parental leave and family-forming assistance.