Director, Credentialing & Licensing

About the company:

Octave is a modern behavioral health practice creating a new standard for care delivery that’s both high-quality and accessible. With in-person and virtual clinics in multiple states, the company offers evidence-based individual, couples, and family therapy, while pioneering relationships with payers to make care more affordable through insurance. By raising the bar on how care is delivered and how providers are supported, we are building a sustainable system that values equity, affordability, and effectiveness.

Job Summary:  

As a Director, Credentialing & Licensing in a high-growth mental health startup, you will support the Credentialing team and collaborate with Revenue Operations leadership to execute strategic initiatives. Your responsibilities include overseeing and optimizing the entire credentialing process, managing a team of professionals, ensuring accurate and timely processing and ongoing maintenance of provider files. Implementing process improvements to enhance efficiency and accuracy. You will also work closely with various departments to align credentialing activities with organizational goals, providing strategic leadership and operational support as the department scales.

Management Responsibilities: 

• Develops, coordinates, and implements  systems, policies, procedures, and productivity standards.
• Provide leadership and guidance to the team, ensuring the achievement of goals and objectives.
• Foster a positive and collaborative work environment.
• Oversee the planning, execution, and completion of projects and initiatives within the team.
• Establish and monitor operational processes and workflows to enhance efficiency and productivity.
• Streamline operational processes, enhance efficiency, and improve overall organizational performance. 
• Implement best practices, monitor key performance indicators (KPIs), and develop strategies to achieve operational excellence.
• Ensures a safe, secure, and compliant work environment.
• Accomplishes staff results by communicating job expectations; planning, monitoring, and appraising job results.
• Build and manage a high-performing team, including hiring, training, and development.
• Provide leadership to the team, including setting goals, providing guidance, and ensuring the team's overall success.
• Set performance expectations and goals for team members. Conduct regular performance evaluations, provide feedback, and address performance issues. 
• Identify skill gaps within the team and develop strategies for filling those gaps. Support employee development through training, mentoring, and coaching. Identify high-potential employees and create succession plans.

Responsibilities Include: 

• Act as the SME for Octave as a whole, keeping abreast of credentialing regulatory requirements and opportunities.
• Maintain current delegation agreements and pursue new delegation arrangements while meeting payor requirements. 
• Review and adjust all policies and procedures regularly to ensure compliance.
• Perform quarterly audits to ensure adherence to policies and procedures.
• Build and lead a team of credentialing professionals and leaders dedicated to a culture of continuous improvement. 
• Oversee the completion of key credentialing initiatives along with maintenance of ongoing initiatives, collaborating with various Octave stakeholders (e.g., Marketing, Finance, Provider Experience). 
• Develop and execute the licensing strategy in alignment with company goals; lead and mentor a team of licensing professionals to ensure optimal performance.
• Oversee the full licensing lifecycle for providers or facilities, including initial applications, renewals, verifications, and expirations, ensuring accuracy and timeliness.
• Maintain a deep understanding of state and federal licensing regulations, ensuring all licensing activities meet compliance standards; manage risk by proactively identifying regulatory changes and implementing necessary updates.
• Build networks outside of Octave to support the mission and objectives. 
• Create strategy for the team to ensure a path for growth and opportunity.
• Conduct regular analysis of team metrics to ensure organizational objectives are being met. 
• Provide key metric analysis to the leadership team on a monthly and quarterly basis. 
• Collaborate with leaders from other teams, ensuring alignment on key initiatives within the organization. 
• Analyze data to prioritize projects and manage the daily throughput of the credentialing team and external vendors. 
• Develop and maintain detailed staffing models and be accountable for keeping the team on budget. 
• Align team leaders to goals with organizational objectives, providing guidance and support. 
• Oversee provider satisfaction metrics to ensure the team is meeting SLA’s and expectations. 
• Manages and resolves conflicts constructively, addressing and mitigating conflict situations to foster a cooperative workplace atmosphere and maintain team cohesion.

Preferred Requirements:

• Minimum of 7 years of experience in provider credentialing; preferred candidates will demonstrate hands-on proficiency across the process. 
• 7+ years of experience in credentialing and for professional licensing, including 4+ years in a leadership or managerial role.
• Bachelor’s Degree in a related field or equivalent work experience. 
• Experience devising, outlining, communicating, and implementing complex project plans and seeing them through to timely completion - with proven results. 
• Strong understanding of credentialing and  licensing requirements and regulations at both state and federal levels; familiarity with compliance standards.
• Proven track record of devising, communicating, and implementing complex project plans, ensuring timely completion and delivering tangible results. 
• Proficiency in data analysis, with the ability to present insights that inform business decisions effectively. 
• Strong foundation in customer service, both internally and externally. 
• Ability to meet deadlines, and effectively engage stakeholders to drive initiatives forward.  
• Demonstrates accountability for meeting deadlines and delivering on commitments. 
• Excellent written and verbal communication skills, with the ability to foster cross-functional relationships and collaborate effectively within teams.