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Manager, Credentialing (Quality)

Remote

About Medallion:

At Medallion, we believe healthcare teams should focus on what truly matters—delivering exceptional patient care. That’s why we’ve built a leading provider operations platform to eliminate the administrative bottlenecks that slow healthcare organizations down. By automating licensing, credentialing, payer enrollment, and compliance monitoring, Medallion empowers healthcare operations teams to streamline their workflows, improve provider satisfaction, and accelerate revenue generation, all while ensuring superior patient outcomes.

As one of the fastest-growing healthcare technology companies—ranked No. 3 on Inc. Magazine’s 2024 Fastest-Growing Private Companies in the Pacific Region, No. 5 on LinkedIn's 2024 Top Startups in the US, a Glassdoor Best Place to Work in 2024 & 2025, and featured on The Today Show—Medallion is revolutionizing provider network management. Our CEO, Derek Lo, has been named one of the Top 50 Healthcare Technology CEOs of 2024 by The Healthcare Technology Report. Backed by $130M in funding from world-class investors like Sequoia Capital, Google Ventures, Optum Ventures, Salesforce Ventures, Acrew Capital, Washington Harbour, and NFDG, we’re on a mission to transform healthcare at scale.

We prioritize candidate safety. Please be aware that official communication will only come from @medallion.co email addresses.

About the Role:

Our Credentialing team is core to our business and is responsible for making sure all of the licensing and credentialing tasks that we take on for our customers is completed efficiently and accurately. As a Credentialing Manager, you will be responsible for overseeing the day-to-day activities of the Credentialing department to ensure smooth and efficient operations.

The Credentialing Manager's primary objective is to develop a comprehensive understanding of Medallion's credentialing processes and client-specific workflows. They will leverage this expertise to effectively guide and communicate these processes and workflows to the credentialing team, ensuring seamless execution and alignment with client expectations. This role will have a strong understanding of NCQA complaint credentialing along with the ability to adapt our credentialing workflows to meet client demands. 

This role reports to the Director of Operations, and base compensation may land between $90,000-$115,000. In addition to base salary, Medallion offers equity and benefits as part of the total compensation package. Many factors are considered when determining pay including: market data, geographic location, skills, qualifications, experience, and level.

 

Core Responsibilities:

  • Partner with our engineering team to define feature requirements, participate in testing, provide feedback, and translate product updates into clear, scalable SOPs.
  • Implement, and maintain audit frameworks—including establishing audit criteria, sampling methodologies, and evaluation standards
  • Collaborate closely with the Implementation team to gather customer requirements and document them in SOPs to ensure consistent, repeatable execution. 
  • Manage 2 QA agents and specialists in completing regular audits; analyze audit trends and partner with the Credentialing over production to drive ongoing process improvements. 
  • Surface operational risks, workflow blockers, or emerging trends proactively to leadership to ensure smooth execution. 
  • Assist in training new team members on process changes, product updates, and new SOPs to ensure successful onboarding and adoption. 
  • Support rollout planning for new features, workflows, and SOPs by coordinating across EPD, EMs, and Implementation teams.
  • Partner with analytics and ops teams to measure the impact of workflow changes on efficiency, accuracy, and customer outcomes. 
  • Join escalated customer calls as needed. 

 

You’d be a great fit if…

  • 3+ years of provider credentialing experience, specifically working with NCQA criteria
  • 2+ years of experience managing credentialing teams
  • Experience working in credentialing software systems
  • Computer literacy in Google Suite and Microsoft Office products
  • Experience working with Airtable. 
  • Experience in a client facing role
  • Demonstrated ability to manage multiple priorities in a fast-paced environment
  • Strong organizational and time management skills
  • Attention to detail and a high degree of accuracy in work
  • Excellent interpersonal skills and ability to work with and manage a variety of people
  • Experience setting up or managing QA audits, including defining audit criteria and evaluating performance 
  • Ability to analyze data to identify trends, risks, and opportunities to improve workflows

 

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