Quality Assurance Specialist – Credentialing

Lyra Health is seeking a Quality Assurance Specialist – Credentialing to build and maintain a highly compliant, audit-ready credentialing program aligned with The Joint Commission (TJC) and NCQA standards. This role is critical in ensuring the integrity, accuracy, and compliance of provider credentialing files and processes across a nationwide network of mental health providers and group practices.

Requirements

• 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.

Benefits

• Comprehensive healthcare coverage
• Lyra for Lyrians; coaching and therapy services
• Equity in the company through discretionary restricted stock units
• Competitive time off with pay policies including vacation, sick days, and company holidays
• Paid parental leave
• 401K with up to 3% matching
• Monthly tech allowance

Originally posted on Himalayas