Remote Credentialing Analyst - Health Plan/Managed Care

Medlinkhealth Anesthesia Associates; Dallas (TX); On-site; USD 60,000 - 75,000; Full time

Job summary

Medlinkhealth Anesthesia Associates is seeking a Credentialing Analyst to support health plan credentialing programs in compliance with NCQA and regulatory standards. You will evaluate practitioners and facilities, perform data analysis, and oversee credentialing data to ensure directory accuracy.

Fully remote eligibility is available for qualified Texas residents. The role requires 3+ years in managed care or credentialing, a Bachelor’s degree, and strong Excel/Adobe Pro skills, with NAMSS

Qualifications

• 3+ years in managed care or credentialing
• Bachelor’s degree as stated
• Proficient Excel with VLOOKUP
• Experience with CAQH/NCQA/NPDB preferred
• NAMSS certification highly preferred
• Familiarity with provider data management practices

Responsibilities

• Verify and process initial credentialing and re-credentialing for practitioners and facilities to ensure NCQA/regulatory compliance.
• Gather, analyze, and track provider data for directory updates, billing setup, and internal reporting.
• Assist with oversight audits of delegated and non-delegated provider groups; identify data discrepancies and suggest improvements.
• Interface with credentialing databases and partner organizations to streamline application processing and respond to provider inquiries.
• Maintain confidentiality of provider credentials and personal information per policies.

Skills

Managed care experience

Analytical skills

Communication skills

Education

Bachelor's degree in Healthcare/Business/Health Admin

Tools

Excel (VLOOKUP, advanced)

Adobe Pro

Outlook

SharePoint

Job description

Medlinkhealth Anesthesia Associates is seeking a Credentialing Analyst to support health plan credentialing programs in compliance with NCQA and regulatory standards. You will evaluate practitioners and facilities, perform data analysis, and oversee credentialing data to ensure directory accuracy.

Fully remote eligibility is available for qualified Texas residents. The role requires 3+ years in managed care or credentialing, a Bachelor’s degree, and strong Excel/Adobe Pro skills, with NAMSS