Kandi O'Brien, CMPE

Kandi O’Brien is a highly accomplished healthcare operations and management executive with over 20 years of leadership experience in the healthcare industry.  

Her expertise in developing comprehensive credentialing and compliance programs has consistently led to meeting requirements for NCQA, URAC, Medicare, Medicaid, and state and federal regulations. Kandi joined MHR as an independent Consultant in July 2024. She collaborates closely with healthcare providers and organizations to design and implement credentialing programs that meet NCQA standards and state and federal requirements.

Kandi’s leadership roles span various healthcare organizations, from major national health systems to medical review organizations and physician practices. She has held positions of VP of Operations, senior director, operations manager, and compliance officer. Among her many accomplishments is establishing delegated credentialing programs for multiple organizations, enabling them to meet NCQA standards and pass major payer audits.  She has led the strategic launch of start-up organizations, developing operational and marketing strategies while managing physician contracting and staffing models.

Previously, as Director of Credentialing and Enrollment at Privia Health, Kandi managed the integration of new groups and territories nationwide, overseeing all credentialing delegation activities to ensure requirements with NCQA standards and state and federal regulations.

During her tenure as Senior Director of Credentialing at Refresh Mental Health, Kandi established a credentialing program and managed a team that oversaw over 5,000 providers with delegated agreements and implemented innovative software systems and payer audits.

While Manager of Delegated Credentialing at Aetna nationwide, Kandi oversaw all delegation of credentialing functions and compliance for Medicare, Medicaid, and Workers' Compensation programs, overseeing a team of auditors responsible for contracting with over 800 delegates while meeting NCQA requirements.

Kandi holds a Bachelor of Science in Organizational Management degree from Daniel Webster College. She is a Certified Medical Practice Executive (CMPE) recognized by the American College of Medical Practice Executives.

Kandi lives in Florida and loves to travel, scuba dive and spend time on the water. She is passionate about animals and also volunteers at a free medical clinic.