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Delegated Credentialing Specialist

Job in New York, New York County, New York, 10261, USA
Listing for: Tava Health
Full Time position
Listed on 2026-10-01
Job specializations:
  • Healthcare
    Healthcare Administration
Salary/Wage Range or Industry Benchmark: 65000 - 90000 USD Yearly USD 65000.00 90000.00 YEAR
Job Description & How to Apply Below
Location: New York

ABOUT TAVA

At Tava Health, we believe mental health care should be as accessible and stigma-free as a checkup. We're reimagining the entire experience: from how people find a therapist to how providers deliver care, so more individuals can get the support they need, when they need it.

We’re a fast-growing team on a bold mission: to make high-quality mental health care available to everyone. If you’re passionate about using technology to solve meaningful problems and create lasting change, we’d love to meet you.

ABOUT THE ROLE

The Delegated Credentialing Specialist owns the day-to-day execution of Tava Health’s delegated credentialing program across assigned payer relationships. This role manages payer audits, compliance reporting, audit-ready credentialing files, corrective action plans, provider-data reconciliation, and credentialing operations while partnering closely with internal teams and delegated entities. The role also supports day-to-day credentialing for Nurse Practitioners and group practices.

WHAT YOU'LL DO

Payer Delegation

  • 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.

Credentialing Committee

  • 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.
  • NP and Group Practice Credentialing
  • 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.
REQUIREMENTS
  • 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.
  • High-growth/tech-enabled healthcare…
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