Lead and oversee credentialing operations while ensuring compliance with The Joint Commission standards and drive continuous improvement across credentialing policies and systems.
● Oversee the end-to-end credentialing and recredentialing processes for all providers, ensuring accuracy, timeliness, and compliance with regulatory and accreditation standards.
● Serve as the primary subject matter expert for Joint Commission standards, maintaining continuous survey readiness and leading accreditation efforts.
● Develop, implement, and enhance credentialing policies, procedures, and workflows to align with Joint Commission, NCQA (if applicable), and state/federal requirements.
● Monitor credentialing activities to ensure compliance with internal standards and external regulatory requirements, identifying and addressing gaps proactively.
● Lead internal audits and prepare documentation for Joint Commission surveys, mock audits, and ongoing compliance reviews.
● Supervise and support credentialing staff, providing guidance, training, and performance oversight to ensure high-quality execution.
● Collaborate cross-functionally with Enrollment, Compliance, Legal, Provider Operations, and Revenue Cycle teams to ensure credentialing alignment and operational readiness.
● Maintain accurate and complete provider credentialing records within credentialing systems and ensure data integrity across platforms.
● Track licensure, certifications, sanctions, and expirables, ensuring timely renewals and adherence to compliance requirements.
● Serve as a point of escalation for complex credentialing issues, provider concerns, and audit findings.
● Identify opportunities for process improvement, automation, and scalability to enhance efficiency and reduce risk.
● Stay current on changes to Joint Commission standards, industry best practices, and regulatory requirements, ensuring timely implementation of updates.● Bachelor’s degree preferred (or equivalent work experience).
● 4+ years of credentialing experience in a healthcare organization, hospital, health system, CVO, or behavioral health setting.
● 2+ years of experience in a lead or supervisory role preferred.
● Strong working knowledge of Joint Commission credentialing and accreditation standards (required).
● Experience supporting or leading Joint Commission surveys and audit readiness efforts strongly preferred.
● Familiarity with NCQA standards is a plus.
● Experience with credentialing platforms (e.g., CredentialStream, Verifiable, or similar systems) and provider data management tools.
● Exceptional attention to detail with the ability to manage multiple priorities and deadlines in a fast-paced environment.
● Strong analytical, organizational, and problem-solving skills.
● Excellent written and verbal communication skills, with the ability to collaborate effectively across teams and levels of the organization.
● Proven ability to build, improve, and scale operational processes.
● Self-starter who takes initiative, drives accountability, and ensures follow-through on critical compliance activities.Lyra Health provides comprehensive mental health benefits and support specifically designed for employers, serving over 20 million people globally. Their integrated, AI-powered platform ensures high-quality counseling services and transformative care that leads to faster recovery and reduced healthcare costs for companies.
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