Credentialing Program Lead

Modern Health 

Modern Health is a mental health benefits platform for employers. We are the first global mental health solution to offer employees access to one-on-one, group, and self-serve digital resources for their emotional, professional, social, financial, and physical well-being needs—all within a single platform. Whether someone wants to proactively manage stress or treat depression, Modern Health guides people to the right care at the right time. We empower companies to help all their employees be the best version of themselves, and believe in meeting people wherever they are in their mental health journey.

Modern Health is backed by investors like Kleiner Perkins, Founders Fund, John Doerr, Y Combinator, and Battery Ventures and raised more than $170 million in less than two years, making Modern Health the fastest entirely female-founded company in the U.S. to reach Unicorn status.

More about our culture and what you can expect when you join the team:

“It Takes a Village” culture . Modern Health has a unique and unabashed culture centered around high empathy and high accountability - with a drive to win. We are energized by bringing together the best talent in the industry to achieve audacious goals focused on making mental health a strength and priority for all.

We have an obsession to win. We are highly ambitious and passionate about the work that we do.  We take pride in delivering excellence and our personal best and we continuously innovate to uniquely solve our customers’ needs. 

We are accountable and can rely on each other. We are a team and hold ourselves and each other accountable. We believe in transparent communication and continuous feedback to foster a culture of trust, reliability, and growth. 

We demonstrate empathy. We have a supportive and diverse culture where we bolster and uplift each other as we pursue our lofty goals. We encourage selflessness and a willingness to support others, fostering a collaborative and respectful environment. 

We exhibit a bias towards action. This is a fast-paced environment. We jump into problems and initiate solutions. We empower our people to make decisions and experiment, iterate, and repeat until we get it right. 

Modern Health is a fully remote workforce and a hyper-growth company that is often recognized for its excellence, winning awards such as World’s Most Innovative Companies of 2023 by Fast Company, Top 25 Companies of San Francisco 2023 , and 2023 Well-Being Trailblazer Award . To protect our culture and help our team stay connected, we require overlapping hours for everyone. While many roles may function from anywhere in the world—see individual job listing for more—US based team members who live outside the Pacific time zone are expected to work at least six hours between 8 am and 5 pm Pacific time each workday.

We are looking for driven, creative, and passionate individuals to join in our mission. An inclusive and diverse culture are key components of mental well-being in the workplace, and that starts with how we build our own team. If you're excited about a role, we'd love to hear from you!

Credentialing Program Lead

The Role

Modern Health is looking for a Credentialing Program Lead to lead and optimize our credentialing program for a growing provider network.

This is an individual contributor role to start. You will serve as the primary owner of credentialing program execution and continuous improvement, strengthening the policies, workflows, recredentialing standards, audit readiness, reporting, and governance already in place to support a scalable, compliant provider network.

This is a high-impact role for someone who is equal parts program lead, operator, and subject matter expert. You are comfortable improving existing processes, identifying gaps and opportunities, and translating regulatory requirements into practical, scalable workflows while driving cross-functional execution without direct people management.

This role is eligible for remote work within the USA, with the exception of Hawaii.

What You’ll Do

Lead and optimize Modern Health’s credentialing program, including initial credentialing, recredentialing, ongoing monitoring, exception handling, and documentation standards

Lead the administration and operations of the Credentialing Committee, including agenda development, case preparation, primary source verification review, documentation management, meeting facilitation, decision tracking, and follow-up activities.

Ensure credentialing and recredentialing activities are conducted in accordance with organizational policies, accreditation standards, regulatory requirements, and the enterprise quality governance structure.

Improve and scale policies, SOPs, controls, and governance processes aligned with regulatory and accreditation requirements

Define and refine program goals, SLAs, metrics, and reporting to monitor timeliness, quality, audit readiness, and operational performance

Streamline workflows for licensure, sanctions, exclusions, malpractice, expirables, renewals, and issue resolution

Serve as a key liaison across Provider Operations, Clinical Quality, Compliance, Legal, and Recruiting/Onboarding to strengthen provider credentialing oversight, mitigate organizational risk, support audit readiness, and drive accountability to Quality Committee priorities.

Identify process, tooling, and vendor opportunities that improve scalability, visibility, and provider experience

Serve as the credentialing SME for audits, escalations, governance reviews, and credentialing-related provider status decisions

Support day-to-day credentialing operations while driving a more scalable future-state model

Who You Are / Requirements:

5+ years of experience leading and optimizing credentialing programs, provider operations, provider enrollment, licensing, or a related healthcare operations function

Experience administering Credentialing Committee activities, provider governance processes, audits, and regulatory reviews.

Knowledge of credentialing and recredentialing standards, including NCQA, URAC, state regulatory requirements, and delegated credentialing arrangements.

Experience improving credentialing infrastructure, policies, workflows, controls, or operating models in a growing environment

Experience with credentialing software, provider data management systems, primary source verification tools, CAQH, NPDB, provider lifecycle management platforms and credentialing documentation requirements.

Experience supporting audits, accreditation readiness, delegated credentialing oversight, or similar compliance programs

Strong program management, analytical, and cross-functional communication skills

Comfortable balancing strategic process improvement with hands-on operational execution.

 Applicants must be able to maintain work authorization for the duration of employment without employer sponsorship or employer-provided training plans or attestations (including, for example, the Form I-983 required for STEM OPT). Immigration sponsorship is not available for this position.

Preferred Qualifications

Experience in digital health, telehealth, behavioral health, or a multi-state provider network environment

Experience with credentialing platforms, provider data systems, or vendor oversight

Certified Provider Credentialing Specialist (CPCS), Certified Professional Medical Services Management (CPMSM), or equivalent credentialing certification preferred.

What Success Looks Like

Within the first 12 months, this person has:

Improved key credentialing policies, SOPs, and audit-ready documentation

Strengthened SLAs, reporting, and governance mechanisms

Regulatory-compliance credentialing, recredentialing, and ongoing monitoring

Increased cross-functional alignment across Provider Operations, Clinical Quality, Compliance, Legal, and Recruiting / Onboarding

Improved scalability, consistency, and operational execution as the provider network grows

Benefits

Fundamentals:

Medical / Dental / Vision / Disability / Life Insurance 

High Deductible Health Plan with Health Savings Account (HSA) option

Flexible Spending Account (FSA)

Access to coaches and therapists through Modern Health's platform

Generous Time Off 

Company-wide Collective Pause Days 

Family Support:

Parental Leave Policy 

Family Forming Benefit through Carrot

Family Assistance Benefit through UrbanSitter

Professional Development:

Professional Development Stipend

Financial Wellness:

401k

Financial Planning Benefit through Origin

But wait there’s more…!  

Annual Wellness Stipend to use on items that promote your overall well being 

New Hire Stipend to help cover work-from-home setup costs

ModSquad Community: Virtual events like active ERGs, holiday themed activities, team-building events and more

Monthly Cell Phone Reimbursement

Equal Pay for Equal Work Act Information

Please refer to the ranges below to find the starting annual pay range for individuals applying to work remotely from the following locations for this role.

Zone 1: San Francisco Bay Area and New York City Metro

Zone 2: All other California locations and Seattle, WA

Zone 3: All other New York locations, All other Washington locations, Washington DC, Austin, TX, CT, IL, MA, NH, NJ, OR, RI, VT

Zone 4: All other Texas locations, AL, AK, AZ, AR, CO, DE, FL, GA, HI, ID, IN, IA, KS, KY, LA, ME, MD, MI, MN, MS, MO, MT, NE, NV, NM, NC, ND, OH, OK, PA, SC, SD, TN, UT, VA, WV, WI, WY

Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies, and experience and may fall outside of the range shown. Ranges are not necessarily indicative of the associated starting pay range in other locations. Full-time employees are also eligible for Modern Health's equity program and incredible benefits package. See our Careers page for more information.

Depending on the scope of the role, some ranges are indicative of On Target Earnings (OTE) and includes both base pay and commission at 100% achievement of established targets.

Zone 1 $121,600 — $143,000 USD

Zone 2 $109,440 — $128,700 USD

Zone 3 $97,280 — $114,400 USD

Zone 4 $91,163 — $107,250 USD

Below, we are asking you to complete identity information for the Equal Employment Opportunity Commission (EEOC). While we are required by law to ask these questions in the format provided by the EEOC, at Modern Health we know that gender is not binary, and we recognize that these categories do not reflect our employees' full range of identities.