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Specialist III, Enrollment Operations
Job summary
Work model
About The Role
The Delegated Credentialing Specialist is a core member of Grow Therapy's Enrollment Operations team, responsible for managing the full lifecycle of delegated credentialing agreements with health insurance payors. This role sits at the intersection of compliance, payor relationships, and operational execution - and is critical to maintaining Grow Therapy's ability to contract and operate under delegated contracts at scale. The ideal candidate brings deep familiarity with NCQA standards, delegated oversight requirements, and the audit processes that govern delegated agreements, and can operate with a high degree of autonomy in a fast-moving environment.
- Manage end-to-end delegated credentialing operations across an assigned portfolio of payors, including pre-delegation audits, ongoing compliance, quarterly reporting, and annual audits
- Serve as the primary point of contact for delegated payor relationships, handling communications, data requests, and issue resolution with cross-functional teams
- Prepare, coordinate, and execute both pre-delegation and annual credentialing audits, ensuring documentation, files, and processes meet NCQA and payor-specific standards, and resolve any Corrective Action Plans identified during audits
- Develop and maintain audit-ready credentialing files, including primary source verification documentation, credentialing committee records, and adverse action tracking
- Build and deliver reporting packages for submission to delegated entities & payors, including monthly delegated rosters, annual audits, and credentialing activity summaries on required cadences
- Coordinate with internal stakeholders (enrollment, partnerships, RCM, legal & compliance, special projects) to ensure provider data is accurate and current across systems, and perform regular roster reconciliations with delegated entities
- Assist in the review and expectations of new Delegated Contract Agreements and implement processes to meet new DCA obligations
- Track regulatory and accreditation changes (NCQA, state-specific requirements) to ensure compliance with regulatory guidelines & industry standards
You'd be a great fit if...
- You have 2-5 years of enrollment or credentialing experience, with at least 2 years of experience with delegated credentialing
- You have working knowledge of NCQA credentialing standards
- You've demonstrated experience preparing for and participating in delegated credentialing audits
- You have the ability to manage multiple payor relationships and deadlines simultaneously without close supervision
- You have high attention to detail with strong documentation habits
- You're comfortable working cross-functionally and communicating clearly with both operational peers and payor contacts
- You have experience in a high-growth or tech-enabled healthcare environment (preferred); telehealth or behavioral health background is a plus
Employment Details
Employment Type: Hourly, Non-Exempt
Base Compensation: The hourly compensation rate for this position is $28.84 per hour.
Fully Remote Commitment: This role is fully remote. Both arrangements include travel 2-3 times per year (e.g., company and department offsites).
If you don't meet every single requirement, but are still interested in the job, please apply. Nobody checks every box, and Grow believes the perfect candidate is more than just a resume.
Note: Please upload your resume in PDF format.