Delegated Credentialing Specialist

Job Summary

Managing the full lifecycle of delegated credentialing agreements with health insurance payors, the part-time hourly Delegated Credentialing Specialist will operate remotely, ensuring compliance, conducting audits, and serving as the primary contact for payor relationships.

Key responsibilities

• Manage end-to-end delegated credentialing operations, including audits, compliance, and reporting
• Serve as the primary point of contact for delegated payor relationships, handling communications and issue resolution
• Prepare and execute credentialing audits, ensuring adherence to NCQA and payor-specific standards

Required qualifications

• 2-5 years of enrollment or credentialing experience, with at least 2 years in delegated credentialing
• Working knowledge of NCQA credentialing standards
• Experience preparing for and participating in delegated credentialing audits
• Ability to manage multiple payor relationships and deadlines simultaneously
• Experience in a high-growth or tech-enabled healthcare environment preferred