Senior Credentialing Specialist – Facilities & Vendors

Healthfirst; New Jersey; In loco; USD 43.000 - 66.000; Tempo pieno

Descrizione del lavoro

Healthfirst Credentialing department credentials and re-credentials providers, facilities and vendors; prepares hard-copy directories and reviews network provider data for accuracy and ensures compliance with regulatory requirements and federal and state regulations.

Minimum qualifications include a high school diploma or GED, with preferred Bachelor’s degree. The role involves audits, data coordination, cross-team communication, and process improvements to uphold regulatory standards.

Competenze

• HS diploma or GED required.
• Facility credentialing experience.
• Strong communication and problem-solving skills preferred.

Mansioni

• 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.

Conoscenze

Time and project management

Critical/creative thinking

Communication

Problem-solving skills

Formazione

HS diploma/GED

Bachelor’s degree

Strumenti

Adobe

Access

Excel

Word

PowerPoint

Office

Descrizione del lavoro

Healthfirst Credentialing department credentials and re-credentials providers, facilities and vendors; prepares hard-copy directories and reviews network provider data for accuracy and ensures compliance with regulatory requirements and federal and state regulations.

Minimum qualifications include a high school diploma or GED, with preferred Bachelor’s degree. The role involves audits, data coordination, cross-team communication, and process improvements to uphold regulatory standards.