Director of Licensing & Credentialing

Company: Talkiatry
Location: New York
Posted on: May 26, 2025

Job Description:

We are seeking an experienced Director, Credentialing & Licensing Operations to provide strategic and operational leadership across our credentialing and licensing functions. Reporting to the SVP of Operations, this role will oversee the full provider onboarding lifecycle - from initial credentialing and licensing, through recredendialing and license renewals, to delegated payor credentialing audits.The Director will lead a team of Credentialing and Licensing Leads, drive delegation compliance standards, and serve as the operational point of contact for external audit activities. The Director will also partner with Payer Relations and Legal to help negotiate delegated credentialing requirements and redline contract language with payors.The ideal candidate is a proven leader who excels at cross-functional collaboration, regulatory interpretation, and process optimization in a high-volume, SLA-driven environment. The Director must be a visionary operational architect, player-coach, passionate about leveraging automation, technology, and systems-driven process design to scale and transform Credentialing & Licensing operations for growth. As a key member of the Operations leadership team, this role will also play a strategic role in helping guide decisions related to market prioritization and cross-licensing strategy.About Talkiatry:Talkiatry transforms psychiatry with accessible, human, and responsible care. We're a national mental health practice co-founded by a patient and a triple-board-certified psychiatrist to solve the problems both groups face in accessing and providing the highest quality treatment.60% of adults in the U.S. with a diagnosable mental illness go untreated every year because care is inaccessible, while 45% of clinicians are out of network with insurers because reimbursement rates are low, and paperwork is unduly burdensome.With innovative technology and a human-centered philosophy, we provide patients with the care they need-and allow psychiatrists to focus on why they got into medicine.You will:

• Strategic Leadership
• Set vision, priorities, and performance expectations across Credentialing and Licensing functions.
• Lead and mentor a team of Leads responsible for licensing, credentialing operations, and delegated payor audit preparation.
• Lead the internal NCQA accreditation program for Credentialing & Licensing, and ensure compliance with all related standards.
• Develop and optimizeTalkiatry's cross-licensing strategy in coordination with Clinical Operations, Strategic Operations, Recruiting, and Marketing.
• Lead the internal PMHNP state activation process by partnering with Clinical and Licensing teams to assess scope of practice and independent practice requirements prior to clinical activation.
• Develop and implement scalable policies, SOPs, and operational frameworks to reduce risk and improve process efficiency.
• Drive adoption of technology-enabled process improvements and workflow automation to optimize Credentialing & Licensing operations.
  • Delegated Credentialing Compliance & Risk Mitigation
  • Own operational accountability for compliance with NCQA standards and delegated payor credentialing contracts.
  • Lead preparation for delegated payor audits and maintain documentation controls to ensure audit readiness.
  • Lead the internal PMHNP state activation process by partnering with Clinical Operations to assess scope of practice and independent practice requirements prior to clinical activation.
  • Coordinate resolution of DEA-related provider escalations and ensure regulatory alignment.
  • Identify operational risks and establish escalation pathways for documentation or compliance gaps.
    • Performance Management & Reporting
    • Define KPIs and SLAs for Credentialing and Licensing teams; monitor team performance and drive continuous improvement.
    • Prepare operational reports and risk assessments for executive leadership.
    • Manage vendor relationships (e.g., Medallion, Verifiable, CVOs) and ensure vendor accountability against service agreements.
      • Cross-Functional & Organizational Collaboration
      • Serve as the senior operational partner to Clinical Leadership, Compliance, Strategic Operations, Clinical Operations, Recruiting, Marketing, and Payer Relations to align provider onboarding, cross-licensing, and credentialing operations.
      • Act as an internal consultant on regulatory and market-entry requirements related to licensing and credentialing.
      • Lead internal communication and training efforts related to credentialing and licensing policy or process changes.You have:
        • 12+ years of experience in healthcare credentialing, licensing, or provider network operations, with at least 3 years in a leadership role.
        • Strong expertise in NCQA standards, CMS requirements, and delegated credentialing frameworks.
        • Proven experience managing delegated payor audits and supporting delegated payor contract negotiations.
        • Experience overseeing licensing operations across multi-state environments and designing cross-licensing strategies.
        • Demonstrated leadership in a high-volume, SLA-driven operational function.
        • Experience designing and optimizing credentialing and licensing workflows for automation and scalability to support organizational growth.
        • Strong understanding of regulatory requirements and risk management related to provider onboarding and market expansion.
        • Exceptional organizational and problem-solving skills; ability to manage complex workstreams and balance competing priorities.
        • Strong communication and interpersonal skills; able to influence and partner effectively across clinical, legal, compliance, and operational teams.
        • Experience working with credentialing and licensing platforms (e.g., Medallion, Verifiable) preferred.
        • Bachelor's degree required; Master's degree or industry certification (e.g., CPCS, CPMSM) preferred.Why Talkiatry:
          • Top-notch team: Join a diverse, motivated group committed to reshaping mental health care.
          • Collaborative environment: Work in a supportive setting where innovation is encouraged.
          • Flexible hybrid location: While this is a field-based role, you'll also have the flexibility to work from home and visit our Manhattan office (NoMad) as needed.
          • Excellent benefits: Talkiatry offers comprehensive medical, dental, and vision plans effective from day one, 401K with match, generous PTO, paid holidays, paid parental leave, and more.
          • Growth potential: As Talkiatry expands, you'll have opportunities to enhance your skills and advance your career.
          • Meaningful impact: Help remove barriers to mental health care in underserved communities and make a tangible difference in the lives of patients and providers.$160,000 - $180,000 a yearCompensation range for this position is $160,000-$180,000, depending on experience; actual compensation will be dependent upon the specific role, location, as well as the individual's qualifications, experience, skills and certifications.Talkiatry participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. only after a job offer is accepted and Form I-9 is completed. For more information on E-Verify, please visit the following: & .At Talkiatry, we are an equal opportunity employer committed to a diverse, inclusive, and equitable workplace and candidate experience. We strive to create an environment where everyone has a sense of belonging and purpose, and where we learn from the unique experiences of those around us.We encourage all qualified candidates to apply regardless of race, color, ancestry, religion, national origin, sexual orientation, age, citizenship, marital or family status, disability, gender, gender identity or expression, pregnancy or caregiver status, veteran status, or any other legally protected status.
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Keywords: Talkiatry, Lower Merion , Director of Licensing & Credentialing, Executive , New York, Pennsylvania