Credentialing Compliance & Delegation Lead

Ardent Health; Nashville (TN); On-site; USD 70,000 - 95,000; Full time

Job summary

Ardent Health in Brentwood, Tennessee seeks a Credentialing Compliance professional to oversee delegation oversight activities, including audit preparation, roster accuracy, oversight reporting, and monitoring compliance of credentialing operations against delegation requirements.

Ideal candidates have strong audit experience, precise documentation habits, and familiarity with NCQA delegation standards, with CPCS certification preferred.

Qualifications

• 4+ years of experience in credentialing, audit, or managed care compliance.
• Experience with credentialing file audit against defined standards.
• Strong analytical and reconciliation skills, particularly with roster and provider data.
• Precise documentation habits and comfort producing audit-ready evidence.

Responsibilities

• Prepares files, documentation, and evidence for payer pre-delegation and annual audits.
• Collaborates with Manager of Credentialing to conduct internal file audits against NCQA and payer-specific delegation requirements; document findings and track remediation.
• Builds, validates, and reconciles delegated rosters for audits prior to submission; investigate and resolve roster discrepancies.
• Compiles quarterly and semi-annual oversight reports required under delegation agreements.
• Monitors ongoing compliance of credentialing operations against delegation standards and escalates gaps.
• Maintains delegation program documentation, polices, agreement records, and audit history.
• Supports the Credentials Committee with reporting and materials as directed.

Skills

Credentialing

Audit

Data analysis

Documentation

Roster management

Education

CPCS certification

Job description

Ardent Health in Brentwood, Tennessee seeks a Credentialing Compliance professional to oversee delegation oversight activities, including audit preparation, roster accuracy, oversight reporting, and monitoring compliance of credentialing operations against delegation requirements.

Ideal candidates have strong audit experience, precise documentation habits, and familiarity with NCQA delegation standards, with CPCS certification preferred.