Lyra Health is seeking a Quality Assurance Specialist – Credentialing to build and maintain a highly compliant, audit-ready credentialing program aligned with The Joint Commission (TJC) and NCQA standards. This role is critical in ensuring the integrity, accuracy, and compliance of provider credentialing files and processes across a nationwide network of mental health providers and group practices.
Requirements
- Conduct comprehensive credentialing file audits and ongoing quality reviews to ensure compliance with TJC and NCQA standards.
- Oversee delegated credentialing arrangements, including CVO performance, ensuring adherence to contractual, regulatory, and accreditation requirements.
- Plan, coordinate, and execute payer credentialing audits, including managing audit documentation, responding to findings, and ensuring timely completion of corrective action plans.
- Track, trend, and report credentialing quality metrics to internal committees, identifying risks, gaps, and opportunities for improvement.
- Review, maintain, and update credentialing policies and standard operating procedures to ensure ongoing alignment with TJC, NCQA, and regulatory requirements.
Benefits
- Comprehensive healthcare coverage
- Lyra for Lyrians; coaching and therapy services
- Equity in the company through discretionary restricted stock units
- Competitive time off with pay policies including vacation, sick days, and company holidays
- Paid parental leave
- 401K with up to 3% matching
- Monthly tech allowance