Credentialing Specialist – Health Plans & CAQH

Tenet Healthcare; Dallas (TX); On-site; USD 52,000 - 70,000; Full time

Job summary

Tenet Healthcare is seeking a credentialing professional to support provider enrollment and credentialing across plans, including Medicare and Medicaid. You will prepare CAQH applications, ensure timely credentialing, and build relationships with health plans.

Candidates should have knowledge of NCQA standards, CAQH, and the ability to travel up to 10% nationally to support multiple facilities and providers.

Qualifications

• Knowledge of NCQA standards and delegated credentialing (as per job summary).
• Experience with health plan credentialing and enrollment including Medicare and Medicaid.
• Ability to prepare/update CAQH applications for providers.

Responsibilities

• Knowledge of credentialing processes including primary source verification.
• Build and maintain relationships with health plans and market/national plans.
• Establish credentialed status to facilitate billing for multiple specialties.
• Maintain credentialing databases with accurate, up-to-date tracking.

Skills

Credentialing

CAQH

Excel

Communication

Travel

Education

High School Diploma

Vocational/Technical Training

Tools

MS Word

Job description

Tenet Healthcare is seeking a credentialing professional to support provider enrollment and credentialing across plans, including Medicare and Medicaid. You will prepare CAQH applications, ensure timely credentialing, and build relationships with health plans.

Candidates should have knowledge of NCQA standards, CAQH, and the ability to travel up to 10% nationally to support multiple facilities and providers.