Senior Facility Credentialing & Compliance Lead

Healthfirst; Pennsylvania; On-site; USD 42,000 - 70,000; Full time

Job summary

Healthfirst is seeking a Credentialing professional to support the credentialing and re-credentialing of providers, facilities, and vendors. The role ensures regulatory compliance and accurate provider data across internal systems and networks.

The candidate will prepare hard-copy and online directories, support quarterly committee meetings, and collaborate with cross-functional teams to uphold Healthfirst policy and contractual obligations.

Qualifications

• HS diploma or GED required.
• Experience with facility credentialing or similar credentialing processes.

Responsibilities

• 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.
• 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.

Skills

Time and project management

Critical/creative thinking

Communication

Problem-solving skills

Education

HS diploma/GED

Facility credentialing

Tools

Adobe

Access

Excel

Word

PowerPoint

Office

Job description

Healthfirst is seeking a Credentialing professional to support the credentialing and re-credentialing of providers, facilities, and vendors. The role ensures regulatory compliance and accurate provider data across internal systems and networks.

The candidate will prepare hard-copy and online directories, support quarterly committee meetings, and collaborate with cross-functional teams to uphold Healthfirst policy and contractual obligations.