Quality Assurance Specialist – Credentialing

Lyra Health

. Conduct comprehensive credentialing file audits and ongoing quality reviews to ensure compliance with TJC and NCQA standards.

Posted 4/23/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $61,000 - $76,000 per yearWebsite

About the role

Key responsibilities & impact

Conduct comprehensive credentialing file audits and ongoing quality reviews to ensure compliance with TJC and NCQA standards.
Oversee delegated credentialing arrangements, including CVO performance, ensuring adherence to contractual, regulatory, and accreditation requirements.
Plan, coordinate, and execute payer credentialing audits, including managing audit documentation, responding to findings, and ensuring timely completion of corrective action plans.
Track, trend, and report credentialing quality metrics to internal committees, identifying risks, gaps, and opportunities for improvement.
Review, maintain, and update credentialing policies and standard operating procedures to ensure ongoing alignment with TJC, NCQA, and regulatory requirements.
Partner with credentialing and provider operations teams to remediate audit findings and implement sustainable process improvements.
Support accreditation readiness efforts by participating in TJC and NCQA surveys, including mock surveys and live accreditation reviews.
Assist in the collection, validation, and submission of required documentation and data for accreditation surveys and regulatory reviews.
Monitor credentialing processes to ensure ongoing compliance with internal policies and external regulatory standards.
Identify compliance risks, escalate issues appropriately, and recommend corrective and preventive actions.
Maintain audit-ready documentation and ensure alignment across credentialing systems, policies, and procedures.
Collaborate cross-functionally with Provider Success, Compliance, Legal, and Operations teams to ensure a consistent and compliant credentialing program.
Contribute to the development and refinement of credentialing QA policies, audit tools, and standard operating procedures.

Requirements

What you’ll need

Bachelor’s degree preferred (or equivalent work experience).
3+ years of credentialing, quality assurance, compliance, or healthcare operations experience, preferably in a behavioral health, hospital, or managed care setting.
Strong knowledge of The Joint Commission and NCQA credentialing and accreditation standards required.
Experience conducting credentialing audits, payer audits, and/or delegation oversight (including CVOs).
Demonstrated experience managing corrective action plans and driving compliance improvements.
Familiarity with accreditation survey processes, including documentation preparation and survey participation.
Strong analytical skills with the ability to track, interpret, and report quality metrics.
Exceptional attention to detail with a focus on accuracy, compliance, and audit readiness.
Excellent communication skills, with the ability to clearly present findings, risks, and recommendations to stakeholders.
Experience with credentialing systems, audit tools, and platforms such as Salesforce, Jira, or similar systems preferred.
Strong organizational and project management skills, with the ability to manage multiple audits and deadlines simultaneously.
Proactive, solutions-oriented mindset with the ability to identify gaps and drive continuous improvement.
Passion for advancing high-quality, compliant mental health care and supporting provider excellence.

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Lyra Health Website LinkedIn All Job Openings 501 - 1000 employees Founded 2015 ⚕️ Healthcare Insurance ☁️ SaaS 👥 HR Tech 💰 $235M Series F on 2022-01 Healthcare Insurance
SaaS
HR Tech Lyra Health is a mental health company that partners with organizations to deliver comprehensive and effective global workforce mental health benefits. By providing evidence-based mental health care, Lyra Health boosts employee well-being and drives business impact. Their platform offers high-quality mental health support through a global network of professionals, utilizing AI matching technology to connect members quickly with suitable providers. Lyra Health serves families, couples, adults, and children, offering support for diverse mental health needs. Their programs aim to improve employee health, productivity, and reduce healthcare costs while providing a seamless member experience. Quality Assurance Specialist – Credentialing Job not on LinkedIn 🔥 49 minutes ago 🇺🇸 United States – Remote 💵 $61k - $76k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 🔧 QA Engineer (Quality Assurance) 🦅 H1B Visa Sponsor Apply Now Find Hiring Managers Customize resume for this job Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Conduct comprehensive credentialing file audits and ongoing quality reviews to ensure compliance with TJC and NCQA standards.
Oversee delegated credentialing arrangements, including CVO performance, ensuring adherence to contractual, regulatory, and accreditation requirements.
Plan, coordinate, and execute payer credentialing audits, including managing audit documentation, responding to findings, and ensuring timely completion of corrective action plans.
Track, trend, and report credentialing quality metrics to internal committees, identifying risks, gaps, and opportunities for improvement.
Review, maintain, and update credentialing policies and standard operating procedures to ensure ongoing alignment with TJC, NCQA, and regulatory requirements.
Partner with credentialing and provider operations teams to remediate audit findings and implement sustainable process improvements.
Support accreditation readiness efforts by participating in TJC and NCQA surveys, including mock surveys and live accreditation reviews.
Assist in the collection, validation, and submission of required documentation and data for accreditation surveys and regulatory reviews.
Monitor credentialing processes to ensure ongoing compliance with internal policies and external regulatory standards.
Identify compliance risks, escalate issues appropriately, and recommend corrective and preventive actions.
Maintain audit-ready documentation and ensure alignment across credentialing systems, policies, and procedures.
Collaborate cross-functionally with Provider Success, Compliance, Legal, and Operations teams to ensure a consistent and compliant credentialing program.
Contribute to the development and refinement of credentialing QA policies, audit tools, and standard operating procedures. 🎯 Requirements
Bachelor’s degree preferred (or equivalent work experience).
3+ years of credentialing, quality assurance, compliance, or healthcare operations experience, preferably in a behavioral health, hospital, or managed care setting.
Strong knowledge of The Joint Commission and NCQA credentialing and accreditation standards required.
Experience conducting credentialing audits, payer audits, and/or delegation oversight (including CVOs).
Demonstrated experience managing corrective action plans and driving compliance improvements.
Familiarity with accreditation survey processes, including documentation preparation and survey participation.
Strong analytical skills with the ability to track, interpret, and report quality metrics.
Exceptional attention to detail with a focus on accuracy, compliance, and audit readiness.
Excellent communication skills, with the ability to clearly present findings, risks, and recommendations to stakeholders.
Experience with credentialing systems, audit tools, and platforms such as Salesforce, Jira, or similar systems preferred.
Strong organizational and project management skills, with the ability to manage multiple audits and deadlines simultaneously.
Proactive, solutions-oriented mindset with the ability to identify gaps and drive continuous improvement.
Passion for advancing high-quality, compliant mental health care and supporting provider excellence. Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Quality Assurance Team Lead 🔥 6 hours ago Mark43 201 - 500 🤖 Artificial Intelligence 🏛️ Government 🔒 Cybersecurity Website LinkedIn All Job Openings Quality Assurance Team Lead at Mark43 guiding Service Quality Engineers to ensure software quality. Collaborating with Engineering and creating testing frameworks and training for the team. 🇺🇸 United States – Remote ⏰ Full Time 🟠 Senior 🔧 QA Engineer (Quality Assurance) 🦅 H1B Visa Sponsor Quality Engineer – Automation Tester 🔥 6 hours ago Accenture Federal Services 10,000+ employees 🤖 Artificial Intelligence 🔒 Cybersecurity 🏛️ Government Website LinkedIn All Job Openings Quality Engineer responsible for developing test automation suites at Accenture Federal Services. Ensuring efficiency and reliability for systems through strong collaboration and technical skills. 🇺🇸 United States – Remote 💵 $82k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 🔧 QA Engineer (Quality Assurance) JavaScript Python Scala Selenium SQL Quality Engineer – Automation Tester 🔥 6 hours ago Accenture Federal Services 10,000+ employees 🤖 Artificial Intelligence 🔒 Cybersecurity 🏛️ Government Website LinkedIn All Job Openings Quality Engineer (Automation Tester) developing, maintaining, and enhancing test automation frameworks for Accenture Federal Services. Collaborating closely with developers and QA teams to ensure software quality and efficiency. 🇺🇸 United States – Remote 💵 $78.5k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 🔧 QA Engineer (Quality Assurance) JavaScript Python Scala Selenium SQL Senior Engineering Manager – QA & Standards 🔥 7 hours ago insightsoftware 1001 - 5000 ☁️ SaaS 💸 Finance 🏢 Enterprise Website LinkedIn All Job Openings Senior Engineering Manager overseeing QA and standards for insightsoftware’s SaaS platform. Driving quality outcomes, AI strategy, and team transformation with a focus on performance engineering. 🇺🇸 United States – Remote 💵 $160k - $201k / year 💰 $798.6M Private Equity Round - insightsoftware on 2021-07 ⏰ Full Time 🟠 Senior 🔧 QA Engineer (Quality Assurance) 🦅 H1B Visa Sponsor Senior QA Analyst, Manual 🔥 12 hours ago UBC 1001 - 5000 🧬 Biotechnology ⚕️ Healthcare Insurance 💊 Pharmaceuticals Website LinkedIn All Job Openings Senior IT QA Analyst conducting manual, batch, and automated testing for a pharmaceutical support company. Ensures software quality and supports QA test environments under general supervision. 🇺🇸 United States – Remote ⏰ Full Time 🟠 Senior 🔧 QA Engineer (Quality Assurance) View More QA Engineer Jobs 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs

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Hard Skills & Tools

credentialingquality assurancecomplianceaccreditationcredentialing auditspayer auditscorrective action plansquality metricsaudit readinessdocumentation preparation

Soft Skills

analytical skillsattention to detailcommunication skillsorganizational skillsproject management skillsproactive mindsetsolutions-oriented mindset