Healthcare Credentialing & Compliance Specialist

Catholic Health Initiatives; Omaha (NE); On-site; USD 26,000 - 37,000; Full time

Job summary

Catholic Health Initiatives is seeking a Credentialing Specialist to manage the end-to-end credentialing and re-credentialing for the CHI Health System, ensuring compliance with Joint Commission, NCQA, URAC, and CMS standards.

Responsibilities include background investigations, primary source verifications, and leveraging the credentialing database to monitor eligibility while collaborating with internal and external stakeholders.

Qualifications

• Requires strong analytical skills to interpret data and maintain accuracy.
• Proficiency in database management and report generation.
• Ability to communicate clearly with internal and external stakeholders.
• Independence in handling confidential information and managing competing priorities.

Responsibilities

• Manage full lifecycle of practitioner files from appointment to privileging.
• Conduct background investigations and primary source verifications.
• Use credentialing database to generate reports and track eligibility.
• Resolve credentialing discrepancies and assist with delegated audits.

Skills

Analytical skills

Database management

Report generation

Communication

Education

GED General Studies

High School Graduate General Studies

Tools

Credentialing database

Job description

Catholic Health Initiatives is seeking a Credentialing Specialist to manage the end-to-end credentialing and re-credentialing for the CHI Health System, ensuring compliance with Joint Commission, NCQA, URAC, and CMS standards.

Responsibilities include background investigations, primary source verifications, and leveraging the credentialing database to monitor eligibility while collaborating with internal and external stakeholders.