Facility Credentialing Lead — Compliance & Vendor Oversight

HealthFirst; New Mexico; On-site; USD 42,000 - 66,000; Full time

Job summary

Healthfirst’s Credentialing department handles provider, facility, and vendor credentialing and re-credentialing, ensuring data accuracy and regulatory compliance. The team prepares hard-copy directories and collaborates with third-party vendors to publish online listings.

They also prepare quarterly presentations for the credentialing and delegate vendor oversight committee and conduct pre-delegation audits to ensure contractual adherence.

Qualifications

• HS diploma or GED required.
• Facility credentialing experience preferred.

Responsibilities

• Credential providers, facilities, and vendors in accordance with regulations and Healthfirst policy.
• Prepare presentations for credentialing and vendor oversight committee meetings.
• Facilitate pre-delegation and delegation vendor audits to ensure contractual adherence.
• Prepare hard-copy directories and coordinate with third party vendors for online postings.
• Communicate effectively with internal departments and external partners.
• Identify opportunities to improve processes for regulatory compliance and state/federal requirements.
• Raise issues to management and assist in resolution.
• Perform additional duties as assigned.

Education

HS diploma/GED

Bachelor’s degree

Tools

Adobe

Access

Excel

Word

PowerPoint

Office

Job description

Healthfirst’s Credentialing department handles provider, facility, and vendor credentialing and re-credentialing, ensuring data accuracy and regulatory compliance. The team prepares hard-copy directories and collaborates with third-party vendors to publish online listings.

They also prepare quarterly presentations for the credentialing and delegate vendor oversight committee and conduct pre-delegation audits to ensure contractual adherence.