Provider Quality Specialist jobs in United States
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Lantern · 7 hours ago

Provider Quality Specialist

Lantern is a specialty care platform dedicated to connecting individuals with top specialists for various medical needs. The Provider Quality Specialist will be responsible for maintaining and enhancing the integrity of Lantern's provider network through quality assurance and requalification initiatives, ensuring compliance with quality standards and clinical guidelines.

Health CareHospitalMedicalMedical DeviceMental Health

Responsibilities

Serve as a point of contact for providers during the requalification process — clearly articulating Lantern’s process, explaining requirements, and reinforcing the shared importance of data integrity and patient safety
Support the re/qualification process for all providers within Lantern’s COE network
Collect, validate, and review documentation including procedure logs, licenses, board certifications, and malpractice history
Facilitate efficient reviews of provider applications by the Qualification Committee by ensuring completeness and accuracy of all provider submissions
Partner with the providers to resolve application issues and escalate cases to the Clinical Operations team when necessary
Partner with Network/Provider Success Managers to ensure timely submission and data integrity for provider requalification applications
Compare refreshed provider data against initial qualification records to identify material changes in practice patterns, quality metrics, or compliance items
Coordinate review workflows with the Provider Qualification Committee for providers requiring further evaluation or requalification
Maintain organized records of provider documentation in Lantern’s SharePoint-based repository and CareHub/HealthCloud/SFDC
Track progress and generate operational dashboards to monitor completion rates, data accuracy, and provider quality metrics over time
Partner with internal teams (Clinical, Provider Success, and Compliance) to evolve qualification standards and optimize workflows
Support audits and special projects to continuously improve data consistency and reduce administrative burden on provider partners
Act as the source of truth for the provider qualification process for the Network team

Qualification

Healthcare OperationsCredentialing StandardsQuality AssuranceData AnalysisMicrosoft ExcelSharePointCRM ToolsStakeholder ManagementCommunication SkillsOrganizational SkillsAttention to DetailTeam Collaboration

Required

Bachelor's degree required; advanced degree or certification in Healthcare Administration, Public Health, or related field preferred
2+ years of experience in healthcare operations, credentialing, or quality assurance (COE, payer, or provider network experience a plus)
Strong analytical and organizational skills with meticulous attention to detail
Proficiency with Microsoft Excel, SharePoint, and CRM tools (e.g., Salesforce)
Excellent communication and stakeholder management skills — the ability to partner effectively with internal teams and external provider groups
Ability to thrive in a fast-paced, dynamic environment with evolving processes

Preferred

Knowledge of credentialing or privileging standards (NPDB, CAQH, NAMSS, NCQA, Joint Commission)

Benefits

Medical Insurance
Dental Insurance
Vision Insurance
Short & Long Term Disability
Life Insurance
401k with company match
Paid Time Off
Paid Parental Leave

Company

Lantern

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Lantern is the specialty care platform connecting people with the best care when they need it most.

Funding

Current Stage
Late Stage
Total Funding
$93M
Key Investors
Insight PartnersDundon Capital PartnersTEXO Ventures
2023-12-19Secondary Market· $92M
2020-10-27Series Unknown
2016-01-12Series C

Leadership Team

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John Zutter
Chief Executive Officer
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Fiona Mulligan
Chief Operating Officer
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Company data provided by crunchbase