Credentialing Analyst (CareBridge)

Elevance Health (Anthem); Nashville (TN); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Elevance Health is seeking a Credentialing Analyst (CareBridge) to join our national virtual provider operations. The role involves complex credentialing activities, audits, and oversight for the Credentials Committee with collaboration across internal teams.

You will support licensing, file reviews, data analysis, and issue resolution while ensuring adherence to policies and timelines. This position offers hybrid/work-flexible arrangements near a designated office.

Qualifications

• Requires a high school diploma or equivalent with at least 3 years in a managed care environment.
• Experience with frontline providers is preferred.
• Familiarity with NPPES, PECOS, CAQH, and Medallion platforms is a plus.

Responsibilities

• Supports licensing and credentialing for a national virtual provider group.
• Performs credentials file audits to ensure timeliness and quality documentation.
• Reviews files for accuracy and completeness with vendors.
• Analyzes performance data to predefined standards.
• Interacts with clinical teams to obtain information for Credentials Committee review.
• Utilizes internal systems and runs reports to resolve credentialing queries.
• Monitors license actions, complaints, and sanctions for Managers review.

Skills

Time management

Organizational skills

Provider enrollment

Frontline provider experience

Education

High school diploma or equivalent

Tools

NPPES

PECOS

CAQH

Medallion Platforms

Job description

Anticipated End Date: 2026-09-24

Position Title: Credentialing Analyst (CareBridge)

Job Description: Credentialing Analyst

Location

This is a virtual eligible role. You should be within a reasonable proximity to one of our offices.

Hours

General business hours, Monday through Friday.

Virtual

This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Role Overview

The Credentialing Analyst performs more complex activities in support of provider credentialing to include additional research, auditing, managing credentialing appeals, special projects, delegation oversight, and site visits.

How will you make an impact

• Supports overall licensing and credentialing efforts for a national virtual provider group
• Performs credentials file audits to ensure timeliness of processing, quality of documentation, and adherence to company and department policies.
• Performs quality review of files to determine accuracy and completeness of all necessary documentation from associated vendors.
• Analyzes performance data to predetermined standards.
• Interacts with internal clinical frontline and leadership to obtain information, provide status updates, research issues necessary for Credentials Committee review.
• Utilizes internal systems and runs reports/queries to research provider questions and resolve issues.
• Monitors license actions, complaints, and sanctions and obtains necessary information for Managers review.

Required Qualifications

• Requires a H.S. diploma or equivalent and minimum of 3 years' experience in a managed care environment; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications

• Familiarity with NPPES, PECOS, CAQH, and Medallion Platforms
• Strong organizational and time management skills
• Experience in NLC, Medicaid Provider Enrollment, and Provider Collaboration Agreement Management experience.
• Experience working with frontline providers.

Job Level

Non-Management Non-Exempt

Job Family

PND > Credentialing & Licensing

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

Benefits

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Workplace Policy

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

COVID-19 Vaccination

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Equal Employment Opportunity

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gen