Temporary Senior Facility Credentialing Specialist

HealthFirst; Sioux Falls (SD); On-site; USD 50,000 - 75,000; Full time

Job summary

Healthfirst in Sioux Falls is seeking a Credentialing Specialist to manage provider, facility, and vendor credentialing and re-credentialing, prepare directories, and align data with state and federal regulations. You will support audits, coordinate with third-party vendors, and help maintain accurate records for regulatory compliance.

The role requires a HS diploma/GED with experience in credentialing; a Bachelor’s degree and strong time/project management, critical/creative thinking,

Qualifications

• HS diploma or GED required.
• Facility credentialing experience or exposure preferred.
• Bachelor’s degree and relevant experience are a plus.
• Strong time and project management, critical/creative thinking, communication, and problem-solving skills.
• Proficiency in Microsoft software: Adobe, Access, Excel, Word, PowerPoint, Office.

Responsibilities

• Credential and re-credential providers, facilities, and vendors.
• Prepare hard-copy directories and coordinate with third-party vendors for online postings.
• Review network provider data for accuracy and regulatory compliance.
• Support quarterly credentialing and vendor oversight committee meetings.
• Facilitate audits to ensure adherence to contractual obligations.
• Identify process improvement opportunities and raise issues to management.

Skills

Time management

Project management

Critical thinking

Creative thinking

Communication

Problem-solving

Education

HS diploma/GED

Bachelor's degree

Tools

Adobe

Access

Excel

Word

PowerPoint

Office

Job description

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
• 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

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to or calling. In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC.

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All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.