Senior Credentialing & Licensing Operations Associate

The Senior Credentialing & Licensing Operations Associate will be a subject matter expert in behavioral health provider credentialing, ensuring the accuracy, compliance, and scalability of our provider network operations. This role will own core credentialing processes—including initial credentialing, delegated and non-delegated enrollments, and recredentialing—while managing a third-party vendor for primary source verification. The ideal candidate is highly skilled in NCQA credentialing standards and health plan interpretations, capable of applying judgment on compliance nuances, and confident in holding external partners accountable to high-quality performance.

What you will do:

• Credential: Oversee provider credentialing lifecycle, including primary source verification, initial credentialing, delegated roster submissions, non-delegated enrollments, and recredentialing.
• Interpret: Serve as a subject matter expert on NCQA credentialing standards and health plan variations, applying judgment and escalating to compliance/legal as needed.
• Manage Vendors: Monitor credentialing vendor performance against SLAs, hold accountable to quality standards, and escalate performance issues when necessary.
• Maintain Compliance: Ensure credentialing processes meet NCQA requirements, contractual obligations, and audit-readiness.
• Document: Maintain accurate credentialing records, SOPs, and committee documentation.
• Collaborate: Partner cross-functionally to ensure alignment on credentialing workflows, escalations, and provider communications.
• Support Licensing: Assist with state licensing applications and renewals as needed.

What you will bring:

Required Skills:

• 5+ years of experience in behavioral health provider credentialing.
• Deep knowledge of NCQA credentialing standards and health plan interpretations.
• Strong vendor management skills with experience monitoring SLAs and quality performance.
• Demonstrated ability to make judgment calls on compliance and escalate appropriately.
• Highly organized and detail-oriented, with excellent documentation skills.
• Strong communication skills and ability to collaborate cross-functionally.
• High level of accountability, ownership, and integrity.

Preferred Skills:

• Experience with state licensing applications and renewals.
• Digital health and/or start-up experience.
• Familiarity with Availity, Medallion, and/or similar primary source verification platforms.

Location:

We are currently hiring this role remotely in the US and Hybrid for San Francisco (SF) and Los Angeles (LA). Candidates must permanently reside in the US full-time.
For candidates with a primary residence in the greater SF and LA areas, this role will follow our hybrid model. You’ll work 3 days per week from our office, allowing for impactful in-office collaboration and connection, while enjoying the flexibility of remote work for the rest of the week. Your recruiter will share more details about our hybrid model.

Pay & Benefits:

The anticipated new hire base salary range for this full-time position is $79,200-$110,000 + equity + benefits.