CertifyOS

CertifyOS

API-driven credentialing and provider enrollment platform

Credentialing Team Lead

Full-Time
No salary listed
Senior
Mumbai, Maharashtra, India+3 more

More locations: Pune, Maharashtra, India | Bengaluru, Karnataka, India | New Delhi, Delhi, India

Remote

Must work aligned to Eastern Standard Time (EST) hours.

About the job

Requirements
  • At least 5 years of professional United States health technology and credentialing experience, including at least 2 years managing a team.
  • Proven ability to lead a team of at least 5 people in a production-driven environment.
  • Experience working with cross-functional and global teams.
  • Strong client engagement and stakeholder management experience.
  • A metrics-driven mindset focused on continuous improvement.
  • Ability to balance hands-on execution with long-term operational strategy.
  • Strong organizational, analytical, and problem-solving skills.
  • Excellent written and verbal communication skills.
  • Proven ability to manage daily performance metrics and drive accountability.
Responsibilities
  • Own core operational metrics for the pod, including speed, quality, and efficiency, ensuring service-level agreements are consistently met and quality remains high.
  • Monitor turnaround times and quality metrics daily and weekly, and drive corrective actions to maintain compliance and efficiency.
  • Identify process gaps, document standard operating procedures, and lead internal training to close them.
  • Manage pod escalations, partnering with cross-functional teams to resolve issues quickly and prevent repeat problems.
  • Oversee ongoing monitoring and management of credentialing expirables within the pod.
  • Support workload balancing and capacity planning as volume grows, flagging risks to the manager early.
  • Partner with internal stakeholders to resolve escalations, streamline workflows, and improve operational outcomes.
  • Communicate performance insights upward to the manager, downward to the team, and laterally to peer Team Leads.
  • Prepare ad hoc reports and operational analyses to support decision-making.
  • Support direct client engagement where needed, accurately and professionally representing the pod's work.
  • Lead and manage a pod of Credentialing Specialists and Operations Analysts to ensure timely and accurate file processing.
  • Coach, mentor, and train team members to strengthen credentialing knowledge and regulatory compliance.
  • Oversee workflows to ensure adherence to National Committee for Quality Assurance standards, state guidelines, and client requirements.
  • Conduct daily standups and weekly performance reviews to track throughput, quality, and key metrics.
  • Facilitate performance reviews and deliver performance conversations directly to team members.
  • Support onboarding of new hires, provide guidance during training, and participate in hiring for the pod.
  • Identify attrition risks on the team and proactively raise retention concerns to the manager.
  • Foster team culture by driving collaboration, engagement, and a high-performance mindset within the pod.
Desired Qualifications
  • Knowledge of credentialing processes, provider data management, and healthcare compliance.
  • One to two years of experience in credentialing, provider enrollment, or healthcare operations.
  • Knowledge of National Committee for Quality Assurance guidelines and state and federal credentialing regulations.
  • Skills in SQL, Excel Macros, or related analytical tools.

About the company

CertifyOS provides an automated platform for credentialing, licensing, and enrollment of healthcare providers for payors, health systems, and digital health companies. Its API-first platform pulls data from hundreds of sources to deliver real-time credentialing, ongoing monitoring, and cross-state licensure within one workflow. It differentiates itself with end-to-end API-driven integration and NCQA-aligned compliance to reduce administrative work and speed reimbursement. Its goal is to help clients scale networks efficiently and let providers focus more on patient care by cutting paperwork and coordination.

Company Size

201-500

Company Stage

Series B

Total Funding

$59M

Headquarters

New York City, New York

Founded

2021

Get referred to CertifyOS

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Simplify Jobs

Simplify's Take

What believers are saying

  • The September 2026 national credentialing launch validates CertifyOS with top payers.
  • The June 2025 $40 million Series B extends runway and hiring capacity.
  • Candor Health partnership strengthens provider data accuracy and expands product breadth.

What critics are saying

  • SharedCred depends on insurer adoption before fall 2026; slow rollout delays revenue.
  • CertifyOS must prove accuracy across thousands of sources, or payer trust collapses.
  • Status page showed a March 2026 platform slowdown; reliability risk threatens mission-critical workflows.

What makes CertifyOS unique

  • UnitedHealthcare, Cigna, and Centene chose CertifyOS for SharedCred in September 2026.
  • CertifyOS combines credentialing, enrollment, monitoring, and provider data management in one API.
  • SOC 2 Type 2 compliance and NCQA-aligned workflows support enterprise trust.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Unlimited Paid Time Off

Company Equity

Growth & Insights and Company News

Headcount

6 month growth

↑ 0%

1 year growth

↓ -2%

2 year growth

↑ 8%
PR Newswire
Sep 23rd, 2026
UnitedHealthcare, Cigna, and Centene join first national shared credentialing programme to cut $2B in healthcare costs

CertifyOS has launched the first National Shared Credentialing Program in the US, with initial participants including UnitedHealthcare, Cigna Healthcare, and Centene. The programme aims to eliminate redundant credentialing processes that currently cost the US healthcare system over $2 billion annually. The system creates a centralised platform where providers enter their information once, rather than submitting an average of 17 applications yearly. Health plans currently spend between $200 and $500 per provider per recredentialing cycle, whilst providers spend roughly $700 in time and effort per year on duplicate applications. CertifyOS will standardise credentialing verification across participating health plans, performing primary source verification to NCQA and Medicaid standards. The service is scheduled to launch in autumn 2026. The company, which entered the market in 2021, is backed by General Catalyst and Upfront Ventures.

Modern Healthcare
Sep 23rd, 2026
UnitedHealth, Cigna team with CertifyOS on provider credentialing - Modern Healthcare

UnitedHealth, Cigna team with CertifyOS on provider credentialing - Modern Healthcare. UnitedHealth, Cigna, Centene join forces on provider credentialing. September 23, 2026 05:00 AM CDT Health insurance companies are joining forces to simplify the arduous provider credentialing process.

CertifyOS
Oct 16th, 2025
CertifyOS and Candor Health Partnership Announced

CertifyOS and Candor Health partnership announced. Its strategic partnership streamlines provider data accuracy with integrated change management and credentialing support. CertifyOS has announced a strategic partnership to create the most accurate, intelligent, and scalable Provider Data Management (PDM) solution in the healthcare industry. This collaboration brings together CertifyOS's next-generation Master Data Management (MDM) and provider data infrastructure with Candor Health's unmatched data accuracy engine to transform how health plans manage, verify, and operationalize up-to-date provider data. By combining CertifyOS's scalable and modernized PDM platform with Candor Health's deep expertise in provider data accuracy, the two companies are addressing the fragmentation that has burdened health plans for decades. Together, they unlock the operational efficiency, compliance readiness, and real-time provider intelligence that health plans need to meet evolving regulatory requirements and improve the member experience - all in service of better healthcare outcomes. "Candor leverages AI and machine learning to deliver accurate, near real-time provider data that enhances health plans' operational efficiency, compliance, and member experience," said Sury Agarwal, CEO of Candor Health. "Integrating our up-to-date provider data with CertifyOS's MDM infrastructure creates a unified solution that not only validates and manages provider information but also enables instant actions across a provider network. This collaboration addresses critical gaps in provider data management, offering a scalable and compliant infrastructure that empowers health plans to optimize network operations and deliver seamless care experiences." Trusted by dozens of health plans and digital health organizations, CertifyOS is the leading provider data intelligence company unifying workflows across intake, credentialing, monitoring, provider data management, and roster management. Its end-to-end provider data infrastructure platform ingests provider information from multiple sources, applies AI-driven entity resolution and survivorship rules to reconcile conflicting inputs, and normalizes everything into a single source of truth. By storing data at the atomic level, CertifyOS enables flexible configuration of business rules, seamless integration with downstream systems, and a 360-degree view of each provider. Candor Health further strengthens CertifyOS's platform by using AI to continuously cross-check tens of thousands of sources to confirm critical details - from practice locations and affiliations to specialties, licensure, and availability - and refreshes them on a near real-time basis. By integrating Candor Health's high-fidelity data onto CertifyOS's intelligent infrastructure, health plans can be even more confident that they are working with the most complete and current view of their networks. CertifyOS's platform scales with provider networks and can integrate directly into downstream workflows, such as claims, contracting, and directories. "Accuracy without lasting survivorship and action is meaningless," said Anshul Rathi, CEO of CertifyOS. "Candor is the best in the world at producing precise, up-to-date provider data using AI. CertifyOS is the only platform built to maintain and operationalize it. Together, we're not just offering a better PDM system; we're delivering the accurate infrastructure healthcare has been waiting for." This partnership also accelerates both companies' shared vision of helping health plans move from reactive compliance to proactive provider intelligence. With the combined solution, payers can now streamline provider onboarding, avoid claim denials, prevent fraud, and deliver a better provider and member experience - all while reducing administrative burden. Health plans interested in learning more can contact either organization directly to schedule a tailored demo. About Candor Health Candor Health is an AI-native provider data accuracy platform built to solve one of healthcare's most persistent challenges: unreliable provider information. Powered by a continuously verified, near-real-time national directory, Candor transforms fragmented records into trusted intelligence that flows seamlessly across the healthcare ecosystem. Health plans, health systems, and digital health companies rely on Candor to improve reliable provider search, streamline credentialing, and strengthen member trust. By making provider data a strategic asset, Candor enables organizations to drive measurable business performance, operational efficiency, and better care outcomes. To learn more, visit www.candorhealth.com.

PR Newswire
Oct 2nd, 2025
CertifyOS Launches the Only End-to-End Provider Data Management Platform Designed to Eliminate Fragmentation and Reduce Costs

CertifyOS launches the only end-to-end Provider Data Management platform designed to eliminate fragmentation and reduce costs.

FinSMEs
Jun 26th, 2025
Certify Raises $40M in Series B Funding

Certify raises $40M in Series B funding.