Facility Credentialing & Compliance Lead

Healthfirst; Connecticut; On-site; USD 52,000 - 75,000; Full time

Job summary

Healthfirst is seeking a Credentialing Coordinator to manage provider, facility, and vendor credentialing in compliance with regulations. The role includes preparing reports and directories, and coordinating audits and communications with internal teams and external partners.

Responsibilities span preparing materials for credentialing committees, ensuring data accuracy, and identifying process improvements to uphold regulatory standards. This position reports to the Credentialing Department.

Qualifications

• HS diploma or GED required.
• Facility credentialing experience.
• Bachelor’s degree preferred.
• Strong time and project management, communication, and problem-solving skills.

Responsibilities

• Credentials providers, facilities, and vendors in accordance with regulations and Healthfirst policy.
• Prepares presentations for quarterly credentialing and delegate vendor oversight committee meetings.
• Facilitates pre-delegation and delegation vendor audits to ensure adherence to contractual arrangements.
• Prepares hard-copy directories and works with third party vendors for posting online directories.
• Effectively communicates to internal departments and external partners.
• Identifies and assesses opportunities to improve processes to better ensure regulatory compliance.
• Raises issues to management and assists in resolution.
• Additional duties as assigned.

Skills

Time management

Project management

Critical thinking

Communication skills

Problem solving

Education

HS diploma/GED

Facility credentialing

Tools

Adobe

Access

Excel

Word

PowerPoint

Office

Job description

Healthfirst is seeking a Credentialing Coordinator to manage provider, facility, and vendor credentialing in compliance with regulations. The role includes preparing reports and directories, and coordinating audits and communications with internal teams and external partners.

Responsibilities span preparing materials for credentialing committees, ensuring data accuracy, and identifying process improvements to uphold regulatory standards. This position reports to the Credentialing Department.