Facility Credentialing Leader - Compliance & Audits

HealthFirst; Mississippi; On-site; USD 42,000 - 62,000; Full time

Job summary

HealthFirst seeks a Credentialing Coordinator to manage provider, facility and vendor credentialing and re-credentialing processes, preparing hard-copy directories and reviewing network data for accuracy. You will ensure regulatory compliance with federal and state requirements and collaborate with internal teams and external partners.

The role requires a HS diploma with credentialing experience; a Bachelor’s degree is preferred, along with strong communication, project management and MS Office

Qualifications

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

Responsibilities

• Credentials providers, facilities, and vendors in accordance with regulations and Healthfirst policy.
• Prepares presentations for the 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. Reviews relevant data to ensure accuracy.
• Effectively communicates to internal departments and external partners.
• Identifies and assesses opportunities to improve processes to better ensure regulatory compliance and adherence to state and federal regulations.
• Raises issues to management and assists in resolution.
• Additional duties as assigned.

Skills

Facility credentialing

Time management

Project management

Critical thinking

Creative thinking

Communication

Problem solving

Adobe

Access

Excel

Word

PowerPoint

Office

Education

HS diploma/GED

Bachelor’s degree

Tools

Adobe

Access

Excel

Word

PowerPoint

Office

Job description

HealthFirst seeks a Credentialing Coordinator to manage provider, facility and vendor credentialing and re-credentialing processes, preparing hard-copy directories and reviewing network data for accuracy. You will ensure regulatory compliance with federal and state requirements and collaborate with internal teams and external partners.

The role requires a HS diploma with credentialing experience; a Bachelor’s degree is preferred, along with strong communication, project management and MS Office