Temporary Senior Facility Credentialing Specialist

Healthfirst; Tennessee; On-site; USD 42,000 - 62,000; Full time

Job summary

Healthfirst is seeking a Credentialing professional in Tennessee to credential and re-credential providers, facilities, and vendors, ensuring regulatory compliance.

Responsibilities include preparing hard-copy directories, coordinating with third-party vendors, and presenting data for quarterly oversight meetings. Strong communication and problem-solving skills are essential.

The role supports internal teams and external partners to uphold state and federal regulations and Healthfirst policies.

Qualifications

• HS diploma or GED required.
• Facility credentialing experience preferred.

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. Reviews relevant data to ensure accuracy.
• Effectively communicates to internal departments and external partners.
• Identifies 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

Credentialing

Regulatory compliance

Communication

Problem solving

Education

HS diploma/GED

Bachelor’s degree

Tools

Microsoft Office Suite

Excel

PowerPoint

Access

Adobe Acrobat

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


• 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