Credentialing Lead

Job Title: Credentialing Lead 

Department: Clinical Operations

Reports to: Head of Clinical Operations

About Luna Joy

Luna Joy is a leading provider of mental health services, specializing in supporting women through their mental wellness journey. We offer holistic therapy and medication management to help women overcome challenges like postpartum mental health issues. Our dedicated team of professionals works in a collaborative, flexible, and remote environment, ensuring comprehensive care for our clients. We are rapidly expanding and committed to improving access to quality mental health services across the U.S.

Job Overview

We are looking for a Credentialing Lead to join our growing team. As the Credentialing Lead, you will be responsible for overseeing and executing end-to-end provider credentialing and re-credentialing processes across multiple payers and states. You will ensure compliance with regulatory requirements, payer standards, and internal SLAs while supporting operational scalability as LunaJoy continues to grow.

You will work closely with clinicians, payer representatives, operations, and clinical leadership to ensure providers are credentialed efficiently and accurately, enabling timely access to care for our patients. This role requires strong attention to detail, ownership, and the ability to improve processes in a fast-paced, mission-driven environment.

As part of the LunaJoy team, you will play an essential role in directly contributing to support the mental health journey of one million women with purpose-driven innovation, unwavering compassion, and transformative care. You will need speed to adapt quickly and efficiently, and the drive to be 1% better every day, constantly striving for improvement. Additionally, you will demonstrate compassion and contribute to a positive work environment by giving and getting joy in your daily interactions.

Key Responsibilities:

• Manage end-to-end provider credentialing and re-credentialing across payers and states.
• Oversee payer enrollments (commercial, Medicaid, Medicare) and ensure timely approvals.
• Maintain and update CAQH, licenses, NPIs, DEA, and insurance records.
• Act as the main point of contact for payer communications and follow-ups.
• Track credentialing progress, meet SLAs, and resolve issues or delays.
• Ensure compliance with NCQA, CMS, and payer requirements.
• Support provider onboarding in partnership with Clinical and Operations teams.
• Improve and document credentialing processes and SOPs.
• Audit records, support audits, and report on credentialing metrics.

Qualifications:

• 4+ years of experience in provider credentialing, enrollment, or healthcare operations.
• Proven experience leading or owning credentialing workflows across multiple payers (commercial, Medicaid, Medicare).
• Strong understanding of CAQH, NPI, state licensing boards, and payer enrollment requirements.
• Experience managing initial credentialing, re-credentialing, and ongoing provider maintenance.
• Ability to track, audit, and report credentialing statuses with high accuracy.
• Familiarity with healthcare compliance standards, including NCQA and CMS guidelines.
• Experience working with credentialing software, CRMs, or internal tracking systems.
• Strong understanding of healthcare operations within a multi-state, telehealth environment.

Nice to Haves:

• Prior experience in behavioral health, mental health, or telehealth organizations.
• Experience scaling credentialing operations in high-growth healthcare startups.
• Knowledge of payer contracting processes and timelines.
• Experience training or mentoring credentialing specialists or coordinators.
• Familiarity with data reporting, metrics, and SLA tracking related to credentialing performance.

Soft Skills

• Exceptional attention to detail and organizational skills.
• Strong ownership mindset with the ability to manage priorities independently.
• Clear, professional verbal and written communication skills.
• Collaborative team player who works effectively with cross-functional partners.
• Problem-solver who can identify process gaps and implement improvements.
• Calm and solutions-oriented under time-sensitive or high-volume workloads.

Why Luna Joy?

• Mission-Driven Purpose: Be a part of an organization dedicated to improving access to mental health care, empowering individuals, and creating positive, lasting change in our communities.
• Flexibility & Work-Life Balance: We offer a fully remote work environment that allows you to work from wherever you're most comfortable. Embrace the freedom of remote work while staying connected with a supportive team. This flexibility enables you to create a workspace that fits your needs, allowing you to focus on making a meaningful impact from anywhere.
• Collaborative & Inclusive Culture: Join a community of diverse talent who share your passion for making a difference. We foster a culture of collaboration, growth, and mutual support to help you thrive in your role.
• Rewarding Compensation: We recognize the value of your work with fair pay, bonuses, and opportunities for advancement as we continue to expand our reach and impact in the mental health space.

Compensation & Benefits:

• Compensation Range: $1,500 - $1,800 based on the individual's location, experience, qualifications, and applicable federal and state minimum wage requirements.
• Flexibility and development opportunities.
• Access to educational resources and a supportive community of like-minded professionals.

Inclusion Statement

At Luna Joy, we are committed to fostering a diverse, inclusive, and equitable workplace where all team members feel valued and respected. We believe that diversity of backgrounds, experiences, and perspectives strengthens our ability to support women’s mental health. We encourage individuals from all backgrounds, including those from historically underrepresented groups, to apply and join us in creating a positive impact in our communities. Everyone is welcome at Luna Joy, and we are dedicated to building a work environment where you can thrive and bring your whole self to work.

Interview Process

HR Screen: The first phase involves an initial screening with HR. During this stage, we will discuss your experience, skills, and alignment with Luna Joy’s values and culture. This step ensures that you meet the basic qualifications and provides an opportunity for you to learn more about the company and the role.

Second Phase with Hiring Manager: Candidates who pass the HR screen will move on to an interview with the Hiring Manager. In this phase, we dive deeper into your technical abilities, role-specific competencies, and how you approach challenges. The Hiring Manager will assess your fit within the team and your ability to contribute to Luna Joy’s mission.

Offer Stage: After the second phase, successful candidates will move to the offer stage. We will present a formal offer that includes compensation, benefits, and any additional details about the role. This is also your opportunity to ask any final questions before making your decision.

Onboarding & Training: Once the offer is accepted, the onboarding process begins. You will be guided through setting up tools, learning about Luna Joy’s systems and workflows, and engaging in any role-specific training. This phase ensures a smooth transition into your new role, setting you up for success from day one.