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BetterHelp · 3 days ago

Credentialing Policy and Committee Specialist

United States

Full-time

Remote

Entry, Mid Level

$50K/yr - $70K/yr

2+ years exp

BetterHelp is on a mission to make mental health care more accessible to everyone. The Credentialing Policy and Committee Specialist will be responsible for governance, policy, and oversight of the credentialing function, ensuring compliance with NCQA standards and leading credentialing committee operations.

Health CareHealth DiagnosticsInternetMental HealthTherapeuticsWellness

Responsibilities

Own and maintain all credentialing and recredentialing policies, procedures, and supporting documentation

Ensure ongoing compliance with NCQA, CMS, state, and payer credentialing requirements

Lead regular policy reviews and updates to reflect regulatory changes, operational improvements, and audit findings

Partner with Compliance and Legal teams to ensure alignment with organizational and regulatory standards

Lead the planning, facilitation, and documentation of Credentialing and Appeals Committee meetings

Ensure committees are structured and operated in compliance with NCQA and organizational bylaws

Prepare case summaries, provider files, and decision materials for committee review

Document committee decisions, rationales, and follow-up actions in accordance with audit standards

Oversee credentialing-related adverse actions and appeals processes

Ensure timely, compliant notification of providers and proper documentation of outcomes

Coordinate appeals committee meetings and final determinations

Track and report on credentialing governance metrics, policy compliance, and committee activity

Identify gaps or risks in credentialing processes and recommend mitigation strategies

Support credentialing leadership with readiness assessments and compliance reporting

Qualification

Provider credentialingNCQA standardsCredentialing committee managementPolicy draftingRegulatory interpretationExperience in healthcareAppeals processesWritten communicationAttention to detail