Credentialing & Compliance Specialist

Carelon Employment Company LLC; Florida; Hybrid; USD 70,000 - 100,000; Full time

Job summary

Elevance Health is seeking a Credentialing Coordinator for BioPlus Specialty Pharmacy in Lake Mary, FL. The hybrid role requires 1–2 days in office weekly to support collaboration while offering work-life balance.

The position oversees credentialing activities, audits, and contract compliance, coordinating with vendors to ensure program integrity. Minimum requirements include a BA/BS and 5+ years credentialing experience; strong candidates will have credentialing certification and execution

Qualifications

• Requires a BA/BS degree and at least 5 years credentialing experience.
• Experience coordinating credentialing and re-credentialing processes.

Responsibilities

• Oversee credentialing and re-credentialing activities and audits.
• Act as liaison to delegates and credentialing vendors to ensure program compliance.
• Monitor contract compliance and coordinate changes when required.
• Coordinate and conduct initial, annual and focused audits and provide process improvements.
• Serve as corporate contact with internal partners on problems and audits.
• Provide daily oversight of credentialing operations and ensure delegation standards.

Skills

Credentialing experience

Audits

Education

BA/BS degree

Job description

Elevance Health is seeking a Credentialing Coordinator for BioPlus Specialty Pharmacy in Lake Mary, FL. The hybrid role requires 1–2 days in office weekly to support collaboration while offering work-life balance.

The position oversees credentialing activities, audits, and contract compliance, coordinating with vendors to ensure program integrity. Minimum requirements include a BA/BS and 5+ years credentialing experience; strong candidates will have credentialing certification and execution