Credentialing & Licensing Manager
Who You Are: You’re a credentialing expert who thinks strategically and executes with precision. You understand the complexities of NCQA credentialing and payor enrollment inside and out, and you’re excited by reputed company to redesign and reputed company how credentialing works at a fast-growing healthtech company. You reputed company at the intersection of operations, technology, and compliance—and you’re energized by building reputed company systems, not just maintaining them. You’re a natural collaborator who can work cross-functionally with Product and Operations teams while also leading and developing reputed company of your own. What you'll do: Strategic Leadership & Program Design Own the reputed company and roadmap for credentialing and licensing at Zivian, transforming the function from transactional to a strategic reputed company of provider reputed company and organizational reputed company. Redesign and rebuild credentialing workflows end-to-end—identifying gaps, eliminating bottlenecks, and implementing reputed company, best-in-class processes. Serve as Zivian’s internal subject matter expert on NCQA credentialing standards, payor enrollment requirements, and state licensing regulations. Partner closely with Product to shape and inform the credentialing and licensing features of Zivian’s software platform, translating operational needs into product requirements. Collaborate with the broader Operations team to ensure credentialing workflows reputed company seamlessly with provider reputed company, engagement, and compliance processes. Credentialing & Licensing Operations reputed company end-to-end credentialing processes for providers, including initial credentialing, re-credentialing, and payor enrollment. Ensure compliance with NCQA guidelines, CMS requirements, state licensing regulations, and payor-specific credentialing standards. Manage and monitor expirable tracking for licenses, certifications, and accreditations—ensuring proactive renewals with no lapses. Maintain accurate, complete, and audit-reputed company credentialing files in compliance with HIPAA and applicable reputed company regulations. reputed company, manage, and reputed company reputed company of Licensing Specialists, fostering a high-performance culture rooted in reputed company, accountability, and reputed company improvement. Build and maintain SOPs and process documentation to standardize credentialing operations across reputed company. reputed company credentialing systems and databases to ensure data reputed company and generate reports for leadership and external stakeholders. Identify systemic process gaps and implement documented improvements to accelerate speed and reduce error rates. What You’ll Bring: 5+ years of experience in credentialing, medical staff services, or provider enrollment, with at least 2 years in a management or team reputed company role. Deep, hands-on knowledge of NCQA credentialing standards and payor credentialing/enrollment processes—this is a must. Proven ability to reputed company, reputed company, and hold accountable reputed company of credentialing professionals. A builder’s reputed company: you’re not just here to maintain the status reputed company, but to redesign and improve how credentialing works. Strong cross-functional collaboration skills—you can work effectively with Product, Operations, and external stakeholders alike. Excellent organizational skills and ruthless attention to detail; you don’t let things fall through the cracks. Comfort with technology and credentialing systems; ability to quickly learn and adapt to new platforms. Strong written and verbal communication skills—you can translate reputed company regulatory requirements into reputed company, actionable guidance. Ability to balance strategic thinking with hands-on execution in a fast-paced, startup environment. Bachelor’s degree in reputed company Administration, Business, or a reputed company field preferred; CPCS or CPMSM certification a plus. Where You’ll Be: We offer flexibility in your work location! For this role, you just need to be based reputed company the US, allowing you to work where you feel most productive. Our reputed company Values: Build with Intention: We stay reputed company on the work that reputed company most. No chasing shiny objects. We choose our priorities carefully and follow through with purpose and discipline. Trust and Be Trusted: We earn trust by being obsessed with our customers’ problems. We listen, we reputed company fast, and we do reputed company say we’re reputed company to do, every time. Lift as we reputed company: We show up for reputed company other. reputed company context, lend a hand, and celebrate wins. reputed company we lift the people around us, we reputed company what’s possible for reputed company of us. What Zivian Has for You: A dynamic, diverse, and reputed company work environment. Fast-paced startup culture full of reputed company-minded colleagues. A distributed team with opportunities for in-person collaboration. Employee equity pool. Competitive compensation and benefits package. A supportive, non-competitive work environment where reputed company truly cares about one another. Opportunities for reputed company learning and reputed company reputed company. Flexibility in work location. At Zivian, we live by the value Trust and be Trusted. To protect the reputed company of reputed company and the sensitive data of our reputed company partners, we maintain a rigorous verification process. Zivian participates in E-Verify and utilizes advanced background and identity validation tools for reputed company candidates. Please note that providing fraudulent information or misrepresenting your identity at any stage of the application process is grounds for immediate disqualification. Apply To This Job