Credentialing Quality Analyst

Job Summary

To support credentialing quality and risk management processes, the full-time remote Credentialing Quality Analyst will process high-risk credentialing files, ensure compliance and accuracy, and coordinate meetings with stakeholders, including the Special Credentials Review Committee.

Key responsibilities

• Coordinate meetings with the Special Credentials Review Committee, board members, and legal counsel
• Create, prepare, and present reports for credentialing and legal meetings
• Develop risk assessment packets and manage documentation for high-risk credentialing files

Required qualifications

• 3-5 years of experience in a managed care, business, or healthcare environment with data analysis and reporting skills
• Thorough knowledge of provider credentialing principles and procedures
• Experience managing challenging rejected healthcare provider applications in a credentialing environment
• Associates degree required; Bachelor's degree preferred in a related field
• CPMSM or CPCS certification preferred but not required