Healthcare Credentialing Specialist — Enterprise Programs

Hoag Health System; Newport Beach (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

Hoag Memorial Hospital Presbyterian in Orange County, CA, is seeking a Credentialing Analyst to manage credentialing for physicians and other healthcare staff. You will support processing applications, verify information, and maintain practitioner databases to ensure accuracy and regulatory compliance.

The role involves close collaboration with clinicians and administrative teams to keep records up to date and audit-ready, upholding Hoag’s standards and values.

Qualifications

• High School diploma or equivalent required.
• Proficiency with Microsoft Office (Word, Excel, PowerPoint).
• Experience with NCQA standards preferred.
• MD Staff experience preferred.
• Proficiency with medical terminology preferred.

Responsibilities

• Maintain regulatory and accreditation compliance with relevant organizations.
• Create and carry out credentialing processes for physicians, other healthcare professionals, and sites.
• Assist in ensuring personnel and services adhere to policies, guidelines, regulations, and laws.
• Process credentialing applications and reappointment paperwork for completeness and accuracy.
• Collect and verify significant amounts of verification and accreditation data.
• Maintain databases for practitioners and facilities (education, training, licensure, experience).
• Prepare records for regular audits.
• Maintain communication with practitioners to keep records up to date.
• Demonstrate behaviours consistent with core values and required standards.

Skills

Microsoft Office

Medical terminology

NCQA standards

MD Staff experience

Education

High School diploma or equivalent

Certified Professional Credentialing Analyst (CPCS)

Certified Professional Medical Services Professional (CPMSM)

Job description

Hoag Memorial Hospital Presbyterian in Orange County, CA, is seeking a Credentialing Analyst to manage credentialing for physicians and other healthcare staff. You will support processing applications, verify information, and maintain practitioner databases to ensure accuracy and regulatory compliance.

The role involves close collaboration with clinicians and administrative teams to keep records up to date and audit-ready, upholding Hoag’s standards and values.