CredAlt (soon to be Lanyard Health) is seeking a highly motivated and experienced Head of Credentialing & Payer Enrollment to build and lead our credentialing, enrollment, and privileging department. This pivotal role involves shaping our product, ensuring regulatory compliance, and delivering exceptional customer service in a fast-paced startup environment. This is a remote position based in the United States, offering equity participation and the opportunity to drive significant impact in the healthcare industry.
Founding Head of Credentialing & Payer Enrollment
Compensation:
$60,000 - $80,000 USD + equity.
Overview:
CredAlt (soon to be Lanyard Health) is seeking a highly motivated and experienced Head of Credentialing & Payer Enrollment to build and lead our credentialing, enrollment, and privileging department. This pivotal role involves shaping our product, ensuring regulatory compliance, and delivering exceptional customer service in a fast-paced startup environment. This is a remote position based in the United States, offering equity participation and the opportunity to drive significant impact in the healthcare industry.
About Our Company:
CredAlt (soon to be Lanyard Health) is at the forefront of transforming healthcare credentialing and enrollment. We offer a cutting-edge, AI-driven SaaS platform designed to streamline and optimize the entire credentialing lifecycle. Our solution goes beyond basic verification, proactively preventing fraud and abuse, reducing operational costs, and accelerating payer enrollments.
What sets us apart is our commitment to:
- AI-Powered Intelligence: We leverage advanced AI to automate primary source verification (PSV), conduct proactive provider risk assessments (KYP), and ensure data integrity.
- Real-Time Compliance: Our platform provides 24/7 monitoring of provider credentials, sanctions, and expirations, delivering proactive alerts for immediate action.
- Data Security and Integrity: We prioritize data security with military-grade encryption and ensure reliable data through advanced AI verification.
- Tangible ROI: We empower healthcare organizations to achieve significant cost savings, reduce credentialing time, and expand their network with seamless payer enrollments.
- Future-Forward Innovation: We are developing a robust API to facilitate seamless integration and workflow automation, further enhancing efficiency and connectivity.
- Fraud Prevention: Our system is designed to identify and address fraudulent claims early, preventing costly errors and financial losses.
We are not just a credentialing platform; we are a strategic partner, enabling healthcare organizations to focus on delivering exceptional patient care while we handle the complexities of credentialing and enrollment.
Role Summary:
As the Head of Credentialing & Payer Enrollment, you will be instrumental in establishing and leading our credentialing, enrollment, and privileging department. You will be responsible for ensuring compliance with all regulatory requirements, optimizing workflows, and driving continuous improvement. This role requires a strategic thinker with a strong operational background, excellent communication skills, and a passion for customer success. You will collaborate closely with our product team to identify gaps and shape our platform, and you will directly interact with customers to ensure their needs are met. This is a remote position based in the United States, with a preference for candidates located in North Carolina (Durham/Raleigh area) or Texas (Houston).
Key Responsibilities:
- Develop and implement comprehensive credentialing, enrollment, and privileging policies and procedures.
- Lead and manage all aspects of provider credentialing, ensuring compliance with The Joint Commission, NCQA, CMS, and AAAHC standards.
- Build and manage a high-performing credentialing team.
- Collaborate with the product team to identify and address product gaps, providing valuable customer feedback.
- Serve as the primary point of contact for customer credentialing and enrollment inquiries.
- Maintain accurate and up-to-date provider data in our credentialing database.
- Conduct regular audits and quality assurance checks to ensure compliance and accuracy.
- Proactively identify and implement process improvements to enhance efficiency and effectiveness.
- Provide expert guidance on credentialing best practices and regulatory requirements.
- Drive continuous improvement in credentialing workflows, leveraging technology and automation.
- Work outside of the defined job description for the betterment of the company.
- Embody the Amazon Leadership Principles, including Customer Obsession, Ownership, and Bias for Action.
Qualifications:
- Proven experience in credentialing, enrollment, and privileging, preferably in a CVO or managing a credentialing company.
- Strong understanding of healthcare regulatory requirements and accreditation standards.
- Excellent communication, interpersonal, and problem-solving skills.
- Ability to thrive in a fast-paced, dynamic startup environment.
- Strong leadership and team management skills.
- Customer-centric mindset with a passion for delivering exceptional service.
- Bachelor's degree in a related field or equivalent experience.
- Proficiency in credentialing software and databases.
- Ability to work remotely.
- Must be based in the United States, preference given to candidates in North Carolina (Durham/Raleigh) or Texas (Houston).
Preferred:
- Certification by NAMSS (CPCS and/or CPMSM).
Knowledge, Skills, and Abilities:
- Deep understanding of credentialing and enrollment processes.
- Expert knowledge of healthcare regulatory requirements and accreditation standards.
- Proficiency in credentialing software and databases.
- Strong analytical and problem-solving skills.
- Excellent communication and interpersonal skills.
- Ability to lead and motivate a team.
- Customer-centric approach.
- Ability to work independently and as part of a team.
- Ability to work remotely and independently.
Company Culture and Benefits:
We offer a dynamic and collaborative work environment where innovation and customer focus are valued. This is a remote position, offering flexibility and work-life balance. We provide competitive compensation, comprehensive benefits, and equity participation. You’ll be joining a team of passionate professionals who are committed to transforming the healthcare industry.
Equal Opportunity Employer Statement:
CredAlt is an Equal Opportunity Employer. We are committed to creating an inclusive and diverse workplace where everyone feels valued and respected. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status.
$60,000 - $80,000 per year