Senior Hybrid Credentialing Specialist

Memorial Hermann Health System; Houston (TX); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Memorial Hermann Health System in Houston seeks a Senior Credentialing Specialist to coordinate credentialing activities for physicians and providers, ensuring compliance with regulatory and accrediting standards. The role reports to the Manager of Credentialing and requires strong data analysis, communication, and attention to detail.

The position supports a hybrid schedule with 1 week in office and 1 remote, and emphasizes maintaining high quality standards across initial credentialing,

Qualifications

• Education: Associates degree preferred.
• Licenses/Certifications: None.
• Experience/Knowledge/Skills: 3 years credentialing in managed care or related offices; strong analytics and communication; familiarity with credentialing standards.

Responsibilities

• Implements and monitors credentialing, re-credentialing and privileging of network providers.
• Processes provider applications and loads data into the system with high quality.
• Leads training and conducts file audits; mentors less experienced staff.
• Maintains provider profiling and communicates status to providers by phone and mail.
• Ensures compliance with Joint Commission, NCQA and URAC standards.
• Supports policy maintenance and ensures safe care within budget and quality targets.

Skills

Analytical skills

Communication skills

Credentialing knowledge

Primary source verification

Compliance monitoring

Education

Associates degree preferred

Tools

Microsoft Office

Word

Excel

Job description

Memorial Hermann Health System in Houston seeks a Senior Credentialing Specialist to coordinate credentialing activities for physicians and providers, ensuring compliance with regulatory and accrediting standards. The role reports to the Manager of Credentialing and requires strong data analysis, communication, and attention to detail.

The position supports a hybrid schedule with 1 week in office and 1 remote, and emphasizes maintaining high quality standards across initial credentialing,