Delegated Credentialing Specialist

Tava Health is hiring a Delegated Credentialing Specialist to execute its delegated credentialing program across assigned payer relationships. The role manages payer audits, compliance reporting, credentialing records and operations, and supports credentialing for Nurse Practitioners and group practices.

Responsibilities

• Oversee delegated credentialing activities for an assigned payer portfolio, including readiness reviews, ongoing compliance monitoring, recurring reporting, and annual audits
• Monitor NCQA guidance, state regulations, and other accreditation updates; assess operational impact and implement necessary compliance changes
• Prepare for and facilitate pre-delegation and annual credentialing audits in accordance with NCQA and payer-specific requirements; develop and track corrective action plans through resolution
• Maintain complete, audit-ready credentialing records, including primary source verification, Credentialing Committee documentation, and adverse action logs
• Prepare recurring deliverables for delegated partners and payers, such as provider rosters, audit materials, and credentialing activity reports
• Monitor average time to credential and support targets by identifying delays, managing follow-up, and escalating issues as needed
• Partner with Enrollment, Partnerships, Revenue Cycle, Legal/Compliance, and other teams to maintain accurate provider data and routinely reconcile internal records against delegated payer rosters
• Serve as a reliable point of contact for payer communications related to delegated credentialing activities, audits, provider records, and follow-up items
• Support the implementation of new delegated credentialing agreements, including the processes and controls needed to fulfill contractual requirements
• Serve as the operational lead for Credentialing Committee meetings in consultation with the Committee Chair, owning meeting preparation, execution, and follow-through
• Curate and Maintain accurate Credentialing Committee meeting minutes, training materials, committee records, and follow-up items
• Lead credentialing for Nurse Practitioners, including application review, primary source verification, committee readiness, payer submissions, follow-up, and status tracking
• Support credentialing for group practice providers by coordinating documentation, resolving application gaps, monitoring timelines, and maintaining accurate provider records

Preferred

• High-growth/tech-enabled healthcare background
• behavioral health experience
• Tech-Enabled Healthcare Experience
• High-Growth Environment Experience
• Behavioral Health Experience

Benefits

• Stock options
• Fully-covered medical and dental premiums for you and your family, plus voluntary insurance options
• Free, generous Tava mental health benefit
• Monthly HSA contributions for qualifying enrolled employees
• Generous PTO and paid holidays
• Paid parental leave
• 401(k) retirement plan
• Weekly company-paid lunch via DoorDash and a personal DashPass subscription
• Opportunity to make a meaningful impact at a high-growth, mission-driven company

Company

• Employee mental health benefits and therapy services
• Salt Lake City, Utah, USA
• https://www.tavahealth.com/
• Founded in 2019
• 51-200 employees

Qualifications

• 2–5 years of credentialing and enrollment experience, including at least 2 years specifically focused on delegated credentialing
• Certified Provider Credentialing Specialist (CPCS) certification
• Ability to manage multiple payer relationships and responsibilities with minimal oversight
• Self-motivated team player who thrives in multi-tasking environment and can adjust priorities
• High attention to detail, strong organization, and excellent documentation skills
• Outstanding written and verbal communication
• Familiarity with CAQH, NPDB, PECOS, state licensing resources, credentialing software, and payer rostering tools
• Candidates must have authorization to work in the U.S. without company sponsorship now or in the future
• High-growth/tech-enabled healthcare background
• Behavioral health experience
• 2–5 years of credentialing and enrollment experience, including at least 2 years specifically focused on delegated credentialing.

Required skills

• Behavioral Health, CAQH, Certified Provider Credentialing Specialist (CPCS), Credentialing, Delegated Credentialing, NPDB, PECOS, Provider Enrollment

Preferred skills

• High-growth/tech-enabled healthcare background, behavioral health experience

Experience

• 2-5 years