Open to opportunities

lil Gemini

@lilgemini

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Healthcare operations leader with 7+ years driving NCQA-compliant credentialing and KPI/SLA improvements.

India

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What I'm looking for

I’m looking for remote Operations Manager/Team Lead work where I lead credentialing or compliance operations, protect NCQA/HIPAA accuracy, and improve KPI/SLA performance by coaching remote teams.

I’m a healthcare operations professional with 7+ years of progressive experience in provider credentialing, payor enrollment, team leadership, and process optimization. I manage end-to-end credentialing workflows in full compliance with NCQA guidelines, HIPAA regulations, and state regulatory requirements.

As a Credentialing Team Lead at CertifyOS, I lead a pod of 8+ Credentialing Specialists and Operations Analysts while maintaining 100% NCQA compliance across end-to-end credentialing file processing and provider data management. I own daily and weekly KPI/SLA performance management, run standups and review cadences, and drive corrective action plans that consistently meet or exceed operational targets and client SLAs. I’ve also built training and coaching programmes that improved team accuracy, regulatory knowledge, and operational consistency.

Earlier, as a Senior Operations Analyst and Operations Analyst at CertifyOS, I processed 100+ applications per month with 100% data accuracy, streamlined provider-client communication to reduce turnaround time, and produced guideline documents adopted by the broader operations team. I was recognized three times as Best Employee of the Month, promoted twice within 24 months, and I’m open to remote Operations Manager, Team Lead, and Compliance Operations roles where I can deliver measurable operational outcomes.

Experience

Work history, roles, and key accomplishments

Current

Credentialing Team Lead

Current

CertifyOS

Mar 2026 - Present (3 months)

Led a pod of 8+ Credentialing Specialists and Operations Analysts, maintaining 100% NCQA compliance across end-to-end credentialing file processing and provider data management. Owned daily/weekly KPI & SLA performance management, coached for higher accuracy and regulatory knowledge, and resolved escalated cases with zero SLA breaches.

Provider Credentialing NCQA HIPAA compliance SLA Management Team Leadership Process Optimization Quality Assurance Data Analysis Jira

Senior Operations Analyst

CertifyOS

Mar 2025 - Mar 2026 (1 year)

Processed 100+ provider credentialing, licensure, and payor enrollment applications per month with 100% data accuracy across credentialing and licensing platforms. Researched state-specific provider licensure and CME requirements, streamlined provider-client communication to reduce turnaround time, and supported onboarding/implementation while maintaining regulatory compliance.

Provider Credentialing Payor Enrollment CME Regulatory Compliance HIPAA compliance Documentation Quality Assurance

Operations Analyst

CertifyOS

Apr 2024 - Mar 2025 (11 months)

Completed provider licensure and payor enrollment applications with 100% submission accuracy across all filings and validated provider data to meet US regulatory standards. Researched CME and licensure requirements across jurisdictions, authored guideline documents to reduce research time, and supported ad hoc projects to improve turnaround times.

Payor Enrollment Regulatory Compliance CME Data Validation Process Optimization Workflow Automation Quality Assurance Data Analysis

Corporate Trainer

Koenig Solutions

Sep 2021 - Dec 2021 (3 months)

Designed and delivered corporate training programs for 20+ professionals to improve team performance and compliance with organizational standards. Developed training materials, presentations, and assessment tools aligned to learning objectives and performance benchmarks.

Corporate Training Training Program Design Coaching Compliance Training Presentation Development People Development

Senior Associate

Capline Services

Jun 2021 - Sep 2021 (3 months)

Coordinated onshore and offshore teams for insurance verification workflows, improving end-to-end process efficiency across business units. Improved customer experience by achieving an 80% CSAT through reduced call response times and targeted agent training, while managing transaction reporting with data accuracy and compliance.

Insurance Verification Team Coordination Process Optimization Training Enablement Performance Improvement Compliance Reporting

Programme Coordinator

Bhavishya Trust

Feb 2018 - May 2021 (3 years 3 months)

Managed a team of programme fellows, building capability through structured training, performance monitoring, and regular feedback cycles. Analyzed student-impact data to guide decisions and increased donor contributions by 10% through strategic fundraising planning and stakeholder engagement.

Programme Management Performance Monitoring Stakeholder Management Fundraising Strategy Donor Engagement Reporting Partnership Management

Computer Instructor

Kendriya Vidyalaya Noida

Dec 2015 - Dec 2017 (2 years)

Designed and delivered lesson plans integrating technology into the curriculum, including building students’ word processing and research skills. Managed classroom operations and maintained the institution website with high standards of quality and organization.

Lesson planning Technology Integration Classroom Management Word Processing Research Skills Website Administration