Operations built to uncompromising standards.
Built on Process. Driven by People.
Credentialing, NCQA accreditation, compliance, and quality — delivered to the same uncompromising standard for the physicians, nurse practitioners (NP/APRN), physician assistants (PA), medical groups, and healthcare organizations that run on them.
Book a discovery call →Explore services →Built by a clinician-led team with 18+ years inside health plans, CVOs, and clinical operations.
Managed care, accreditation, clinical ops, and growth.
Structured, accountable, mission-focused execution.
Quality, compliance, and performance at the center.
Compliant operations built on AWS infrastructure.
One standard. Built for every organization that runs on it.
Credentialing, accreditation, compliance, and quality — delivered to the same standard whether you're a solo physician, a PA, a nurse practitioner, a medical group, a health plan, or an NCQA/CMS contractor.
Physicians & MD/DO practices
Credentialing & enrollment, CAQH, payer applications, and the infrastructure to launch or run clean.Nurse practitioners (NP/APRN)
Credentialing & enrollment, APRN Medicare enrollment, and CAQH for advanced practice clinicians.Physician assistants (PA)
Payer credentialing & enrollment, CAQH maintenance, and contract review.Medical groups & clinics
Group credentialing programs, panel & re-credentialing, and CAQH for every provider.Health plans
NCQA readiness, delegation oversight, and quality & UM programs built to standard.TPAs
Credentialing programs, delegation oversight, and CVO readiness as you spin up or scale.CVOs
Build-out from scratch or repair — sequenced to NCQA CVO Certification.NCQA & CMS contractors
Audit readiness, corrective action plans, and compliance infrastructure.Delegated entities
Oversight program design and monitoring that survives a file review.FQHCs & community clinics
Credentialing, compliance, and operational scaffolding.Operational lift, delivered to standard
Six productized services — from a solo practice launch to an NCQA survey-ready organization.
Practice Launch
For clinicians going independent. Entity formation, EIN/NPI registration, CAQH setup, payer applications, a starter policy library, and the operational scaffolding to see your first patient.12–16 weeks · Solo & 2-provider
Credentialing & Enrollment
Credentialing & enrollment for physicians, nurse practitioners, physician assistants, and healthcare organizations. Initial, ongoing, and re-credentialing across commercial, Medicare, Medicaid, and TRS-Care — plus the VA's national C&P contractor panels (QTC, VES, OptumServe, Loyal Source). CAQH maintenance, contract review, fee schedules, and the pursuit work that unsticks stalled files.Project or monthly retainer
NCQA Readiness
For health plans and delegated entities. Pre-survey gap analyses against current standards, file and policy remediation, delegation oversight design, and mock surveys with executive readouts.8–24 weeks by scope
Provider Credentialing & CVO Build-Out
For physicians, NPs/APRNs, PAs, and healthcare organizations. From scratch or repaired. Policies, forms, logs, primary-source verification workflows, and audit infrastructure — sequenced toward NCQA CVO Certification from day one.Phase-based · 4–9 months
Policy Infrastructure
Productized policy libraries written to NCQA, CMS, and state standards — credentialing, quality, UM, member rights, delegation, HIPAA, and OSHA. Editable and brandable for your operations.Off-the-shelf or custom 4–8 weeks
Audit & Compliance
Pre-audit reviews, live audit response, corrective action plans, and ongoing monitoring — on both payer and provider sides. Audits stop being existential when the work is already done.Project or annual retainer
Tell us who you are. See the build.
Pick your organization type and see the services that matter most to you — the same standard, tailored scope.
Launch clean. Get paid on time.
Going independent or running a solo practice — physicians, NPs/APRNs, and PAs get credentialed, contracted, and operationally clean from day one.
Keep every provider credentialed.
Scaling a medical group or clinic — CAQH current, contracts negotiated, and policies that survive a real audit.
Run to NCQA standard.
Readiness, delegation oversight, and quality infrastructure — built, documented, and handed off.
Stand up or scale with confidence.
Credentialing programs, delegation oversight, and CVO readiness for TPAs spinning up or scaling.
Built toward certification.
From scratch or repaired — every build sequenced to NCQA CVO Certification from day one.
Survey-ready. Audit-ready.
Delivering NCQA or CMS programs — get the readiness, remediation, and monitoring that keep findings out.
Compliant from the first patient.
Credentialing, compliance, and operational scaffolding for FQHCs and community clinics.
Care coordination that holds up.
Case management, quality programs, and CMS-aligned operations for ACOs.
A disciplined path to clean operations
Assess, build, transition. Every engagement moves through the same three gates so nothing is left half-documented.
Diagnose — Assess and map.
We assess your current operations, identify gaps, and map exactly what needs to be built, fixed, or formalized.Build — Design and implement.
We design and implement the infrastructure — credentialing systems, policies, workflows, and compliance frameworks.Transition — Hand off clean.
We hand off clean, documented, sustainable operations your team can run independently — no dependency on us to keep going.
An operator, not just a consultant
We've run these programs — not just written recommendations about them.
18+ years in healthcare operations
Deep expertise across managed care, accreditation, clinical operations, and healthcare growth strategy.US Armed Forces veteran-led
Structured. Accountable. Mission-focused leadership built for high-stakes environments.NCQA & CMS expertise
Accreditation, compliance, quality, and operational performance at the center of everything we build.Designed for growth & transition
From practice launches to health plan scaling, TPAs, delegated models, and accreditation readiness.Secure, compliant & fully insured
HIPAA-compliant operations on AWS, aligned with NCQA standards, and fully insured.Standards we build to
Every policy, workflow, and program is written to the frameworks your auditors will use.
SAM.gov registered. Ready to serve.
OpsKR Consulting is a Small Business, Woman-Owned and Minority-Owned firm registered in the System for Award Management (SAM.gov) — positioned to bid on federal and state healthcare contracts as a prime contractor or as a subcontractor on a prime's team.
| NAICS | Description | Position |
|---|---|---|
| 541611 | Administrative Management & General Management Consulting Services | Primary — Core consulting market for operations engagements |
| 541618 | Other Management Consulting Services | ✓ — Consulting scope beyond administrative management |
| 541612 | Human Resources Consulting Services | ✓ — Credentialing & provider operations |
| 541614 | Process, Physical Distribution, and Logistics Consulting Services | ✓ — Process & workflow design |
| 541990 | All Other Professional, Scientific, and Technical Services | ✓ — Professional & technical advisory |
| 541519 | Other Computer Related Services | ✓ — Healthcare IT & compliance support |
| 561110 | Office Administrative Services | ✓ — Provider enrollment & administrative support |
| 611430 | Professional and Management Development Training | ✓ — NCQA, CMS & credentialing education |
These NAICS codes define the contract categories we pursue and the capabilities we bring to prime contractors — from credentialing and provider operations to compliance training and healthcare IT support. That includes credentialing MDs and ARNPs to serve veterans through the VA's four national C&P contractors (QTC, VES, OptumServe, LSGS).
Insights, built to the standard
Articles from the OpsKR team on credentialing, accreditation, and the operations that decide whether you get paid.
The Credentialing Mistake That Costs Practices $40K in the First Year
The taxonomy error. The CAQH attestation window missed. The payer enrollment submitted before the NPI-2 was confirmed in PECOS. A handful of preventable missteps that cost independent practices 6–12 months of revenue — and the checklist most consultants skip.What Most Healthcare Consultants Won't Tell You About NCQA Readiness
Most plans spend months building documentation before anyone validates whether workflows actually meet standards. Here's what the gap looks like from the inside — and what to do now, wherever you are in your cycle.CVO vs. Delegated Credentialing: What Health Plans Get Wrong
Plans and TPAs default to CVO arrangements without understanding the liability they're accepting. How to structure the delegation agreement and what auditors pull when they open the file.How to Build a SNP Model of Care That Passes NCQA Scoring
CMS requires a documented Model of Care for every SNP. Most first submissions fail on care coordination and interdisciplinary care teams. This is the structure that works.Asked before the call
Straight answers on the work that decides whether you get paid.