Temporary Senior Facility Credentialing Specialist

Healthfirst; New Jersey; Vor Ort; USD 43.000 - 66.000; Vollzeit

Zusammenfassung

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.

Qualifikationen

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

Aufgaben

• 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.

Kenntnisse

Time and project management

Critical/creative thinking

Communication

Problem-solving skills

Ausbildung

HS diploma/GED

Bachelor’s degree

Tools

Adobe

Access

Excel

Word

PowerPoint

Office

Jobbeschreibung

The 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.

• 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.

Minimum Qualifications

• HS diploma/GED


• Facility credentialing

Preferred Qualifications

• Bachelor’s degree


• Prior relevant experience


• Time and project management, critical/creative thinking, communication, and problem-solving skills.


• Intermediate Microsoft software skills include Adobe, Access, Excel, Word, PowerPoint, and Office