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, partnering with internal stakeholders to address findings and sustain compliance.
Project manage regulatory-related process changes, ensuring requirements are clearly translated into operational execution.
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, implementing follow-up controls to measure adherence and effectiveness.
Ensure clear, timely communication of procedural changes to impacted teams, supporting understanding and consistent adoption.
Partner with technology and operations teams to support quality assurance for new tools, automation, and AI-enabled solutions as human tasks are replaced or augmented.
Monitor regulatory trends and provider-facing notice requirements, ensuring appropriate operational, technology, and communication updates are coordinated and executed.
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, with the ability to translate findings into sustainable operational improvements.
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