Brightside Health delivers life-saving virtual mental healthcare to everyone who needs it. We are powered by proprietary AI, purpose-built technology, a world-class clinician network, and a care model that rivals the best of in-person treatment. When combined with precision psychiatry and leading-edge therapeutic techniques, we’re able to improve outcomes for those with mild-to-severe clinical depression, anxiety, and other mood disorders.

We take an action-oriented, purposeful approach with everything we do and seek out team members who value collaboration and thoughtful prioritization. As a result, our organization is looking for the brightest and most innovative talent in the industry. We can promise you that, as a member of the Brightside team, you’ll have the opportunity to collaborate alongside smart and driven people while growing your professional skills.

We are looking for an experienced Delegated Credentialing Specialist to join our expanding

credentialing team, reporting directly to the Senior Manager, Credentialing and Enrollment. In this

role, you will be responsible for ensuring compliance with our delegated health plans needs and

requirements. You will partner closely with our commercial team and external payers. Ultimately,

this role will be responsible for accurately and timely submitting rosters, responding to pre and

annual delegation audit requests and assisting our credentialing specialists with recredentialing

tasks. Accuracy and timeliness is important all while building effective relationships with

Contacts.

What you’ll be doing as a Senior Delegated Credentialing Specialist:

• Compile and submit accurate and timely rosters for delegated payers in required format

• Recredential Brightside providers within the required 36-month timeframe.

• Own ongoing monitoring process

• Ensure provider demographic data is kept up to date across all systems including the

• credentialing system and CAQH

• Prepare and facilitate Credentialing Committee Meetings

• Assist with preparation of audits with delegated payers

• Ensure expirables are renewed timely

• Remove providers from appropriate payers and systems when no longer with Brightside

• Perform timely follow-up with providers on all pending items

• Submit and order primary source verifications through CVO and monitor for completion

• Perform the primary source verification according to departmental policies and NCQA

• standards when not completed by a CVO

• Follow-up on submitted applications to completion, escalating to leadership as needed

• Review files processed by CVO for completeness and accuracy

• Respond to internal requests for information including status updates

• Respond to inquiries from providers

• Work with providers to obtain information needed to complete

• credentialing/recredentialing and follow up as necessary

• Work collaboratively across departments

• Maintain confidentiality

• Perform other duties as assigned

Requirements:

• 3+ years of delegated credentialing experience using NCQA and state and federal

• requirements, required

• Experience working with delegated audits required

• CAQH experience required

• Ability to work quickly and efficiently while maintaining accuracy

• Excellent verbal, written, and social skills

• Ability to document activity and maintain accurate records

• Self-starter with the ability to work independently and proactively

• Highly detail oriented

• Able to work under pressure and adapt easily to change

• Consistently create a positive work environment by being team-oriented

• Excellent time and workload management skills

Benefits:

• Competitive hourly pay ($24.00-35.00/hr)

• Fully paid for comprehensive health care (medical, dental, vision)

• Pet Insurance

• Life Insurance & Short / Long Term Disability

• 15 Paid Vacation Days, 3 Paid Sick Days, 3 Paid Personal Days

• Parental Leave

• 401k Plan

• Work remotely with flexible hours

• Additional memberships and perks

Final offer amounts are determined by multiple factors including geographic location as well as candidate experience and expertise. If you have questions on compensation bands, please ask your recruiter.

Brightside Health is committed to equal employment opportunities for all team members. Every decision we make regarding employment is solely based on merit, competence, and performance. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We realize the full promise of diversity and want you to bring your whole self to work every single day.

Research shows that underrepresented groups typically apply only if they meet 100% of the criteria listed. At Brightside, we are dedicated to fair play and encourage women, people of color, and LGBTQ+ job seekers to apply for positions even if they don’t check every box for the role.