Healthcare Credentialing Consultant with AI & Automation Expertise

Hybrid operator-technologist with deep credentialing domain experience ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Credentialing is where revenue quietly bleeds. Every day a provider sits un-credentialed costs $500–$1,000 in lost billing, and the delay is almost never about the provider — it's the manual drag. The same demographic data gets re-keyed across HR, medical staff files, payer portals, CAQH ProView, and NPPES. Primary source verification stalls waiting on medical schools, licensing boards, and the NPDB. Re-attestations go stale, expirables slip, and one MSP leaving can spike the whole team's workload. Meanwhile, the tooling hasn't kept up. AI form-fill helps with one screen, but nobody has closed the gap to end-to-end submission, follow-up, and reconciliation. Payer portals still break RPA bots. NCQA audit prep still buries teams in documentation. We place embedded consultants alongside healthcare clients to fix exactly this — using modern AI to compress credentialing cycle time and strip out the manual rework. We're hiring someone to join our consulting bench and do that work. ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ WHAT YOU'LL DO • Embed with healthcare clients — provider groups, MSOs, digital health, payer-adjacent orgs — to map their credentialing and payer enrollment workflows end-to-end • Identify which steps are best served by modern AI assistants, by purpose-built credentialing platforms, or by workflow automation • Build and prototype automations: document parsing, application auto-population, expirables monitoring, status tracking, and follow-up outreach • Train and coach credentialing teams, MSPs, and ops leads on using modern AI tools well in their day-to-day • Translate observed friction into clear automation briefs and architectural recommendations • Interface confidently with credentialing staff, client executives, and our internal technical team • Help clients evaluate the credentialing tech landscape — CVO partners, payer enrollment software, AI-native platforms — without bias ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ WHO YOU ARE • Deep, hands-on experience in healthcare credentialing or payer enrollment — you've actually worked CAQH ProView profiles, run primary source verification, managed re-attestations, fought payer portals, or built the tools that do • Background as an MSP, credentialing specialist, payer enrollment lead, CVO operator, medical group ops director, OR a healthcare technologist/developer who has shipped credentialing solutions • You speak the language fluently — NCQA, NPDB, NPI, PECOS, CAQH, primary source verification, expirables, revalidations, sanctions screening • You use modern AI assistants daily and have actually built or prototyped automations — not just talked about them — comfortable with no-code automation platforms, scripting, or both • You can sit with non-technical credentialing staff and meet them where they are, then turn around and write a clean automation spec for a technical team • Excellent written and verbal communication; comfortable in front of client executives ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ ALSO A PLUS • Direct development experience — Python/JavaScript, API integration, document AI/OCR, RPA • Experience inside a CVO or with NCQA-accredited credentialing operations • Familiarity with platforms like Symplr, MD-Staff, Verifiable, Modio, CAQH Credentialing Suite, Incredable, or EnrollPilot • Multi-state licensing, telehealth credentialing, or digital-health-specific experience ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ WHAT TO INCLUDE IN YOUR PROPOSAL • A SHORT VIDEO (2–3 MINUTES) INTRODUCING YOURSELF AND WALKING THROUGH YOUR EXPERIENCE — THIS IS REQUIRED. PROPOSALS WITHOUT A VIDEO WILL NOT BE REVIEWED. • One specific example of a credentialing or payer enrollment workflow you've personally improved with technology — what you saw, what you built or changed, and the result (cycle time, error rate, revenue recovered) • Which AI assistants and automation tools you use today, and how • A short note on your credentialing-domain background — years, settings, scale • Your availability ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ If you've lived inside credentialing and taught yourself to automate it, you're the rare hybrid we're looking for — tell us your story.