California Credentialing Specialist
Job Summary
Coordinating the daily operations of the Credentialing unit, the full-time California Credentialing Specialist will manage credentialing activities, ensure compliance with guidelines, and collaborate with interdepartmental units, all while working remotely from California.
Key responsibilities
- Monitor credentialing activities to ensure compliance with regulatory and contractual standards, resolving routine issues
- Collaborate with departments to improve workflows and processes, identifying and addressing issues as needed
- Prepare for regulatory audits and maintain required reports, developing corrective action plans as necessary
Required qualifications
- High School Diploma or equivalent
- At least one year of experience as a credentialing specialist
- Strong knowledge of NCQA, DHCS, DMHC, and CMS credentialing standards
- Experience with credentialing software systems and record-keeping principles
- Ability to read and interpret complex written guidelines and instructions
Complete Job Description
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