Provider Credentialing and Practice Lead

Job description

### **Mission** Neko is redefining what prevention means, from treating illness when it arrives, to sustaining health before it's ever at risk. Our mission: make data-driven, preventative care accessible to more people, before symptoms appear. In a single, non-invasive visit under an hour, proprietary technology and direct clinical care combine to deliver personalised, actionable insights. It's a team that thinks in 10x, not 10%. Every role here plays a part in building a world where prevention is the norm, and where your work genuinely helps people live longer, healthier lives. **Role Purpose** The Clinical Practicec Lead owns practice management for Neko Health's United States professional corporation. The role covers four areas: provider credentialing, SOP organization and maintenance, onboarding operationalization, and compliance assurance. Neko runs a tech-enabled clinical model, and this role is expected to run all four through systems and automation rather than manual tracking. Credentialing: the role holds the credential file for every provider practicing under the PC: license, certification, permitted scope by state, malpractice coverage details and every other expirable, verified at source and kept current so that no provider ever sees a member on a lapsed credential. While Neko does not credential with payers today - this role runs the credentialing gate that clears a provider to practice and removes that clearance when a credential lapses. It supplies provider credentialing data into the clinic compliance systems and works to the credentialing standard and clear-to-practice definition set by the Head of Compliance. SOPs: the role owns the SOP library for US practice operations. The role keeps every SOP current, versioned, and easy to find, and retires SOPs that no longer apply. Onboarding: the role turns each new provider's onboarding plan into a working, tracked sequence: credentialing, system access, training, and clearance to start, in the right order and against a clear timeline. Compliance: the role checks that US practice operations meet the standards set by the Head of Compliance, and reports gaps as they surface. Systems and automation: the role chooses, configures and owns the tooling that carries all of the above — one source of truth for provider data, automated expiry alerts, and workflows that hand off cleanly between Talent Acquisition, the People Team, IT and clinical operations. Status should be visible from the system rather than assembled by hand. As Neko opens further states, credentialing volume and complexity grow faster than headcount, and practice operations grow with them. This role exists to make provider readiness, SOP currency, onboarding execution, and compliance standing a managed process with evidence behind it, built on tooling that scales faster than headcount, rather than a scramble before each launch. **What You'll Deliver in the First 6–12 Months** - A current, auditable register of every clinician's license, credential, and permitted scope by state, held in a single system of record with automated expiry tracking and a named process for renewal before lapse. - A complete credential file per provider practicing under the PC, with primary source verification evidence attached and dated. - A written credentialing procedure covering intake, verification, the clear-to-practice decision, re-verification cycle, and removal of clearance. - The credentialing gate built into the clinician onboarding sequence, so a start date cannot be confirmed without verified credentials. - A current SOP library for US practice operations: indexed, version-controlled, and reviewed on a set cycle. - An onboarding operations sequence that turns each new provider's plan into a tracked timeline from offer to start, with the credentialing gate built in. - Practice operations running in-system rather than on spreadsheets: onboarding, SOP review cycles and compliance checks tracked in Neko's tooling, with the remaining manual steps documented and a plan to remove them. - A compliance status report showing where US practice operations meet the Head of Compliance's standards, and where they do not, generated from the system rather than compiled by hand. **Key Responsibilities** **Provider credentialing and primary source verification** - Run credentialing intake for every new provider joining the PC: application, document collection, and verification at source rather than from candidate-supplied copies. - Verify state medical/nursing licenses, board certification, education and training, work history, and DEA registration where the provider's scope requires it. - Operate the clear-to-practice gate: no provider is released to see members until the credential file is complete and verified. - Maintain the permitted scope by state for each provider and flag to the Head of Compliance any request to practice outside it. **Expirables, re-verification and removal** - Own the expirables calendar for licenses, certifications, DEA registrations, malpractice coverage and any other time-limited credential, driven by automated alerts rather than manual review. - Chase renewals ahead of expiry against defined lead times and escalate when a renewal is at risk. - Remove clearance to practice immediately when a credential lapses and notify the clinical rota owner and the Head of Compliance the same day. - Run the re-verification cycle so credential files do not silently age. **Systems, tooling and automation** - Select, implement and administer the tooling that runs practice operations: credentialing records, expiry tracking, onboarding workflow and SOP version control. - Replace manual tracking with automated alerts, scheduled reporting and system-driven handoffs, and keep a running list of the steps still done by hand. - Define the data structure behind credentialing and onboarding so status can be reported out of the system rather than reconstructed. - Work with IT and, where relevant, product and engineering to integrate practice operations data with adjacent systems instead of maintaining parallel spreadsheets. **SOP organization and maintenance** - Own the SOP library for US practice operations: create, index, and version every procedure. - Review each SOP on a set cycle and update it when a process changes. - Retire SOPs that no longer apply, and flag processes that run without one. - Keep SOPs easy to find and use for the staff who rely on them day to day. **Onboarding operationalization** - Turn each new provider's onboarding plan into a tracked sequence: credentialing, system access, training, and clearance to start. - Own the onboarding timeline from offer to start date, and flag delays before they hit the start date. - Coordinate with Talent Acquisition, the People Team, and clinical operations to keep the sequence moving. - Improve the onboarding sequence as volume grows, including automation of tracking and reminders. **Compliance assurance** - Confirm that US practice operations meet the standards set by the Head of Compliance. - Run periodic checks against those standards, and report gaps as they surface. - Support audits of practice operations with evidence drawn from SOPs, onboarding records, and the credentialing file. - Escalate compliance gaps that need action beyond this role. **Credentialing process, data and reporting** - Keep the credentialing record system accurate and audit-ready, so a credential file can be produced on request without reconstruction. - Report credentialing status, upcoming expiries and blocked providers into the Medical Quality reporting cycle, on a set cadence and drawn from the system of record. - Improve the credentialing process as volume grows, including automation of tracking and reminders. - Prepare the function for payer credentialing and provider enrollment should Neko US move to billing insurance. **About you** **Minimum Requirements** - Experience streamlining clinical or healthcare operations in a tech-enabled environment: you have taken a manual, spreadsheet-run process and rebuilt it as a system-driven workflow, and you can describe what you removed and what changed as a result. - Experience working in a clinical operations capacity – where you were responsible for not just executing but building the systems to ensure credentialing, compliance and other clinical operations processes are handled excellently. - Confident with operational tooling: you configure and administer the systems you depend on rather than raising a ticket for every change, and you are comfortable working with data, reporting and everyday automation. - Direct, hands-on experience of state medical board licensure and clinician credentialing processes, including primary source verification. - Experience maintaining a credentialing database or record system to an audit-ready standard. - Experience developing, organizing, and maintaining SOPs in a clinical or regulated operations setting. - Working knowledge of compliance standards in a healthcare or clinical operations setting, with experience checking operations against them. - Precise and persistent administratively **Preferred** - Experience in a digital health, telehealth or otherwise tech-enabled care setting, where clinical operations run on product and tooling rather than paper. - Hands-on experience with credentialing or provider data platforms, and with the workflow and tracking tools used to run operations day to day. - Experience working alongside product or engineering teams to specify what operational tooling needs to do. - Direct experience provider credentialing in a United States clinical setting, including multi-state credentialing. - Experience of credentialing in a newly opened market or a start-up clinical service where the process did not yet exist. - Experience building an SOP program from scratch in a growing or newly opened operation. **Compensation and Benefits** - Paid Time Off & Holidays - Medical, Dental, Vision, and Life Insurance - 401(k) Retirement Plan - Commuter Benefits - Wellness Rewards Program - Complimentary full Neko scan for you and eligible family members