Facilities Credentialing Lead – Compliance & Data

HealthFirst; Heber (UT); On-site; USD 52,000 - 76,000; Full time

Job summary

HealthFirst credentialing department handles credentialing and re-credentials for providers, facilities and vendors, ensuring accuracy and compliance with federal and state regulations. The team also prepares hard-copy directories and coordinates with third-party vendors for online postings.

Additionally, presentations for quarterly credentialing and delegate vendor oversight committee meetings are prepared, while exploring improvements to processes to strengthen regulatory adherence.

Qualifications

• Credentials role handling for providers, facilities and vendors to ensure regulatory compliance.
• Prepares hard-copy directories and coordinates with third-party vendors for online postings.
• Reviews network provider data for accuracy and regulatory adherence.

Responsibilities

• Credentialing of providers, facilities and vendors per HealthFirst policy.
• Prepare quarterly credentialing and vendor oversight committee materials.
• Identify opportunities to improve processes for regulatory compliance.

Skills

Time management

Project management

Critical thinking

Creative thinking

Communication

Problem solving

Education

Bachelor’s degree

Tools

Adobe

Access

Excel

Word

PowerPoint

Office

Job description

HealthFirst credentialing department handles credentialing and re-credentials for providers, facilities and vendors, ensuring accuracy and compliance with federal and state regulations. The team also prepares hard-copy directories and coordinates with third-party vendors for online postings.

Additionally, presentations for quarterly credentialing and delegate vendor oversight committee meetings are prepared, while exploring improvements to processes to strengthen regulatory adherence.