Delegated Credentialing QA Coordinator

Role overview

This remote role is for a Delegated Credentialing QA Coordinator in the United States, offered through a partner company that handles applications and the rest of the hiring process. The position is centered on quality control, file audits, documentation review, and regulatory alignment for behavioral health provider credentialing.

You will help ensure credentialing work is accurate, compliant, and operationally sound so provider networks remain audit-ready and payer relationships stay strong. The role works across credentialing, enrollment, contracting, and leadership teams to support growth into new markets and improve access to behavioral healthcare.

It is a mission-driven position for someone who brings careful attention to detail, healthcare compliance knowledge, and a mindset geared toward process improvement in a fully remote environment.

Key accountabilities

• Check BCBA and behavioral health provider credentialing packets to confirm they are complete, accurate, and supported by proper primary source verification.
• Carry out regular and on-demand audits of delegated credentialing files to confirm compliance with organizational, payer, accreditation, and regulatory rules.
• Track delegated entities against contractual expectations such as turnaround times, documentation standards, and verification procedures.
• Keep audit tools, monitoring trackers, checklists, and reporting dashboards up to date to measure compliance and highlight improvement opportunities.
• Assist with pre-delegation and annual delegation audits by organizing documentation and maintaining audit readiness.
• Work with credentialing teams to keep processes, policies, and quality standards aligned.
• Review credentialing policies and refresh them to match current regulatory, accreditation, and payer expectations.
• Coordinate with enrollment teams on Medicaid, MCO, and commercial payer applications while improving submission accuracy and efficiency.
• Help build and deliver training materials for internal teams and delegated entities.
• Support quality improvement efforts, process optimization, and expansion into new states and payer networks.

Requirements

The ideal candidate will have a background in healthcare credentialing, delegated credentialing, provider enrollment, quality assurance, or a closely related healthcare operations area, along with strong organization and precision.

• Prior experience in healthcare credentialing, delegated credentialing, provider enrollment, quality assurance, or a related healthcare operations function.
• Working knowledge of credentialing standards, primary source verification, payer requirements, and healthcare compliance practices.
• Exposure to BCBA, behavioral health, or provider network credentialing processes is preferred.
• Experience running audits, maintaining compliance records, and spotting opportunities to improve processes.
• Ability to examine detailed documentation accurately and consistently.
• Strong organizational ability, including handling multiple priorities and meeting deadlines in a remote setting.
• Experience building and maintaining audit tools, dashboards, reports, or tracking systems.
• Clear written and verbal communication skills with the ability to collaborate across teams.
• Ability to create training materials and support internal learning initiatives.
• Highly detail-oriented with a strong commitment to accuracy, compliance, and continuous improvement.
• Comfortable working independently in a fully remote, asynchronous team structure.

Perks and benefits

• Annual compensation between $72,000 and $84,000.
• Fully remote work available from anywhere in the United States.
• Flexible working hours and an asynchronous team culture.
• The chance to support the expansion of accessible behavioral healthcare services.
• A collaborative environment focused on innovation, quality, and operational excellence.
• An inclusive workplace that supports people from a wide range of backgrounds and experiences.

Additional information

This role is being advertised on behalf of a partner employer, which will manage applications and next steps. Applications are reviewed through an AI-assisted matching process that shortlists candidates against the role’s core requirements before passing them to the hiring company. Final decisions, interviews, and assessments are handled by the employer’s internal team.

By applying, candidates acknowledge that personal data will be processed to assess candidacy and shared with the hiring employer under applicable data protection laws, including GDPR where relevant. The recruitment process may also use AI tools to support resume review, application analysis, and consistency checks, but final hiring decisions remain human-led.

The company notes that this opportunity is intended to make a meaningful impact by improving access to high-quality behavioral healthcare services.