At Guidehouse Managed Services, I manage credentialing, recredentialing, facility credentialing, and payer enrollment across 24 states for a dental organization. I review provider documentation against state, specialty, payer, and regulatory requirements, and resolve incomplete or outdated information.
I completed a nine-month internal auditing initiative reviewing credentialing records, documentation accuracy, workflow adherence, and compliance requirements. The review identified process gaps and quality trends and supported corrective actions to strengthen consistency and audit readiness.
I maintain state reference guides, payer contracting grids, and state-specific crosswalks, researching licensing boards, payer policies, and changing requirements to keep workflows current. I also develop SOPs, operational manuals, and job aids for repeatable credentialing and enrollment workflows.
Earlier, at TeleSpecialists, I supported nationwide telehealth credentialing and provider documentation review under NCQA and Joint Commission standards. At LHI / Optum, I supported government healthcare provider networks, reviewed complex files and PSV results, and prepared complete files for credentialing committee review.
