Lead Facility Credentialing & Compliance Specialist

HealthFirst; Maine; On-site; USD 50,000 - 70,000; Full time

Job summary

HealthFirst is seeking a Credentialing Specialist to support credentialing and re-credentialing of providers, facilities, and vendors. You will prepare hard-copy directories, review data for accuracy, and ensure compliance with federal and state regulations.

You will also prepare presentations for credentialing and delegate vendor oversight committee meetings, facilitate audits, and communicate with internal teams and external partners. Additional duties may be assigned as needed.

Qualifications

• HS diploma or GED required.
• Facility credentialing required.
• Bachelor’s degree preferred.
• Prior relevant experience preferred.
• Strong time and project management, critical/creative thinking, communication, and problem-solving skills.
• Proficiency with Microsoft Office suite including Adobe, Access, Excel, Word, PowerPoint.

Responsibilities

• Credential providers, facilities, and vendors per regulations and Healthfirst policy.
• Prepare presentations for credentialing and vendor oversight meetings.
• Facilitate pre-delegation and delegation vendor audits.
• Prepare hard-copy directories and coordinate online directories with third party vendors.
• Communicate effectively with internal departments and external partners.
• Identify opportunities to improve processes for regulatory compliance.
• Raise issues to management and assist in resolution.
• Additional duties as assigned.

Skills

Time management

Project management

Critical thinking

Creative thinking

Communication

Problem-solving

Education

HS diploma/GED

Bachelor’s degree

Tools

Adobe

Access

Excel

Word

PowerPoint

Office

Job description

HealthFirst is seeking a Credentialing Specialist to support credentialing and re-credentialing of providers, facilities, and vendors. You will prepare hard-copy directories, review data for accuracy, and ensure compliance with federal and state regulations.

You will also prepare presentations for credentialing and delegate vendor oversight committee meetings, facilitate audits, and communicate with internal teams and external partners. Additional duties may be assigned as needed.