Credentialing Policy Specialist

Job Summary

A company is looking for a Credentialing Policy and Committee Specialist.

Key Responsibilities

• Maintain and ensure compliance of credentialing policies and procedures with NCQA and regulatory standards
• Lead the planning and documentation of Credentialing and Appeals Committee meetings
• Track credentialing governance metrics and recommend improvements to processes

Required Qualifications

• 2+ years of experience in provider credentialing with a focus on policy and governance
• In-depth knowledge of NCQA credentialing standards
• Experience managing credentialing committees and appeals processes
• Strong writing skills for drafting policies and documentation
• Bachelor's degree or equivalent relevant experience preferred