Credentialing Lead

AndHealth LLC; Columbus (OH); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Paid time off

Job summary

AndHealth LLC is seeking a Credentialing Lead to manage credentialing and re-credentialing for licensed and certified healthcare professionals, ensuring compliance and patient safety. You will coordinate applications, verify licenses, and maintain data accuracy across credentialing platforms.

Work involves collaboration with legal/compliance, leadership, and partner teams, and maintaining organized credentialing schedules and documentation. Equal opportunity employer.

Qualifications

• 3+ years of credentialing licensed and certified healthcare professionals.
• Experience with credentialing software and credentialing databases.
• Knowledge of regulatory requirements for healthcare credentialing (FQHC/HRSA a plus).

Responsibilities

• Coordinate and complete credentialing and re-credentialing applications and timelines.
• Verify licenses and certifications via primary source verification.
• Maintain up-to-date and accurate credentialing data across platforms.
• Produce periodic credentialing reports for leadership.
• Collaborate with legal, compliance, and partner teams on requirements.
• Organize credentialing schedules and documentation systems.

Skills

Credentialing expertise

Regulatory compliance

Attention to detail

Communication skills

Education

Bachelor’s degree

Job description

AndHealth is on a mission to radically improve access and outcomes for the most challenging chronic health conditions, with the goal of making world-class specialty care accessible and affordable to all. We partner with health systems, community health centers, and independent practices to remove barriers to care to ensure all people have access to the care they deserve.

The Opportunity

We are looking for a Credentialing Lead who can play a key role in the processing, credentialing, and re-credentialing of all AndHealth licensed and certified healthcare professionals and collaborating with various teams to maintain compliance and uphold the highest standards of quality and patient safety.

• Ensure timely and compliant submission of initial and renewal applications in the credentialing process.
• Ensure that AndHealth healthcare professionals maintain current credentials and meet the necessary qualifications, certifications, and regulatory requirements to perform their roles.

What you'll do in the role:

• Coordinate and complete credentialing and re-credentialing applications, monitor application statuses, and follow up on required documents as needed.
• Initiate and complete the collection, verification, and maintenance of all AndHealth professionals’ data and documentation within credentialing specific platforms.
• Conduct primary source verification for all AndHealth professional licenses and certifications.
• Ensure AndHealth professionals’ data is up-to-date, accurate, consistent, complete, and valid according to established standards.
• Maintain a highly organized system for credentialing schedules, files, documentation, and tracking mechanisms.
• Provide periodic reports to leadership and respective AndHealth teams credentialing statuses.
• Coordinate with other AndHealth teams to ensure credentialing requests and rosters are kept up to date.
• Maintain knowledge of current partners, government agencies, and general requirements for credentialing AndHealth professionals.
• Collaborate with legal and compliance to ensure adherence to relevant laws, regulations, and contractual obligations.
• Compile and maintain AndHealth professional staff training records required for partners, government agencies, and general credentialing.
• Participate in prospective partner discussions as a credentialing expert to address questions about AndHealth credentialing processes.
• Lead and engage in partner meetings and discussions, proving appropriate and timely response to credentialing processes and timelines.
• Support our AndHealth professional network by simplifying and improving their experience.
• Assist with special projects as needed.

Education & Licensure Requirements:

• Bachelor’s degree is preferred.

Other Skills or Qualifications:

• 3+ years of experience credentialing licensed and certified healthcare professionals (physicians, nurse practitioners, pharmacists, pharmacy techs, health coaches, etc) or experience working in a healthcare-related role.
• Experience in regulatory compliance.
• Experience with credentialing under FQHC and HRSA standards is a plus.
• You subscribe to and are willing to live our core values.
• Impeccable attention to detail and are attentive and present in your work.
• Ability to thrive on change and can quickly adapt to evolving processes to continuously improve credentialing.
• Organized and ability to prioritize work based on changing and challenging deadlines.
• Self-directed and able to work independently, as well as participate in group projects.
• Excellent interpersonal, verbal, and written communication skills.
• Proficiency in Microsoft Office, Google Workspace and utilizing credentialing software and database systems.

Here's what we'dlike to offer you:

• Equal investment and support for our people and patients.
• A fun and ambitious start-up environment with a culture that takes on important things, takes risks, and learns quickly.
• The ability to demonstrate creativity, innovation, and conscientiousness, and find joy in working together.
• A team of highly skilled, incredibly kind, and welcoming employees, every one of whom has something unique to offer.
• We know that the overall success of our business is a collaborative effort, and we strive to provide ongoing opportunities for our employees to learn and grow, both personally and professionally.
• Full-time employees are eligible to participate in our benefits package which includes Medical, Dental, Vision Insurance, Paid time off, Short- and Long-Term Disability, and more.

We are an equal opportunity and affirmative action employer. We embrace diversity and are committed to creating an inclusive environment for all employees. Applicants will be considered for employment without regard to race, religion, gender, gender identity, sexual orientation, national origin, age, disability, or veteran status.