Senior Facility Credentialing & Compliance Specialist

HealthFirst; South Dakota Park (SD); On-site; USD 50,000 - 70,000; Full time

Job summary

Healthfirst is seeking a Credentialing Specialist to manage provider, facility, and vendor credentialing, ensure regulatory compliance, and prepare directories. This role supports audits, data accuracy, and coordination with internal teams and external partners.

The ideal candidate will have an HS diploma or GED with credentialing experience, strong organizational skills, and proficiency in Microsoft Office. Knowledge of audits and regulatory requirements is a plus.

Qualifications

• HS diploma or GED required.
• Facility credentialing is required.
• Bachelor’s degree preferred.
• Strong time and project management, communication, and problem-solving skills.
• Proficiency with Microsoft Office suite and related tools.

Responsibilities

• Credential providers, facilities, and vendors per regulations and Healthfirst policy.
• Prepare quarterly credentialing and vendor oversight presentations.
• Facilitate pre-delegation and delegation vendor audits to ensure adherence to contracts.
• Prepare hard-copy directories and coordinate online postings with third-party vendors.
• Communicate effectively with internal departments and external partners.
• Identify opportunities to improve regulatory compliance and state/federal regulations.
• 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 preferred

Tools

Adobe Acrobat

Microsoft Access

Microsoft Excel

Microsoft Word

PowerPoint

Microsoft Office

Job description

Healthfirst is seeking a Credentialing Specialist to manage provider, facility, and vendor credentialing, ensure regulatory compliance, and prepare directories. This role supports audits, data accuracy, and coordination with internal teams and external partners.

The ideal candidate will have an HS diploma or GED with credentialing experience, strong organizational skills, and proficiency in Microsoft Office. Knowledge of audits and regulatory requirements is a plus.