Lead and develop a team of Quality Assurance Specialists responsible for credentialing and provider data quality oversight
Establish and maintain quality assurance programs supporting credentialing, recredentialing, and provider demographic and directory data changes
Ensure timely and successful completion of delegated credentialing audits
Project manage regulatory-related process changes
Serve as the primary point of contact for regulatory-driven changes impacting credentialing and network services processes
Document and maintain Standard Operating Procedures (SOPs) for new or updated processes
Ensure clear, timely communication of procedural changes to impacted teams
Partner with technology and operations teams to support quality assurance for new tools, automation, and AI-enabled solutions
Monitor regulatory trends and provider-facing notice requirements
Support continuous improvement by identifying quality risks, control gaps, and opportunities to strengthen regulatory and operational outcomes.

Experience leading quality assurance or regulatory operations in a healthcare, insurance, or provider network environment
Strong knowledge of credentialing, recredentialing, and provider data management processes
Proven ability to project manage regulatory or compliance-driven process changes from requirement through implementation
A strong process, documentation, and control mindset, with experience developing SOPs and monitoring adherence
Experience supporting audits and regulatory reviews
Comfort partnering with technology teams to support quality oversight for automation and AI-enabled capabilities
Strong communication skills, with the ability to clearly convey complex regulatory changes to operational teams
A continuous-improvement mindset and the ability to lead through change while maintaining quality and compliance.

Change Management Lead – Quality Assurance

Key skills