Advanced Credentialing Specialist
About The Position
The Advanced Credentialing Specialist supports IU Health’s patient safety, quality, and regulatory compliance objectives by coordinating and executing complex credentialing and privileging activities for medical staff and licensed practitioners. The role conducts and maintains primary source verification; facilitates credentialing, recredentialing, and privileging; supports ongoing clinical competency evaluations; manages peer review activities; and facilitates Medical Staff functions in accordance with Medical Staff Bylaws, organizational policies, accreditation standards, and federal and state regulations. The specialist applies critical thinking and professional judgment to analyze credentialing information, identify discrepancies, evaluate trends and potential risk indicators, and maintain accurate and complete practitioner records in designated systems to support informed, risk-based decision-making. Using advanced knowledge of regulatory and accreditation requirements, the specialist helps ensure compliant credentialing practices and quality outcomes across the organization. The role also serves as a resource and mentor to credentialing staff through training, onboarding, and professional development. It contributes to developing, interpreting, and maintaining credentialing policies and procedures; participates in audits and quality reviews; and leads or supports process improvement initiatives to strengthen operational effectiveness, consistency, compliance, and continuous improvement. IU Health describes its leaders as shaping strategic initiatives, developing teams, and working to improve health outcomes. The organization’s mission, vision, and values include purpose, excellence, compassion, and teamwork.
Requirements
- Bachelor’s degree or equivalent years of experience.
- 2–4 years of relevant experience.
- Proficiency in Microsoft 365 applications, including Word, Excel, PowerPoint, and Outlook.
- Apply critical thinking, analysis, professional judgment, diplomacy, adaptability, and effective oral and written communication.
- Work in alignment with departmental goals and organizational direction.
Nice To Haves
- Certified Provider Credentialing Specialist (CPCS) certification.
- Working knowledge of credentialing software.
Responsibilities
- Conduct and maintain comprehensive primary source verification.
- Facilitate credentialing, recredentialing, and privileging processes for medical staff and licensed practitioners.
- Support ongoing clinical competency evaluations and manage peer review activities.
- Facilitate Medical Staff functions in accordance with Medical Staff Bylaws, organizational policies, accreditation standards, and federal and state regulations.
- Analyze credentialing information, identify discrepancies, evaluate trends and potential risk indicators, and maintain accurate, complete practitioner records in designated systems.
- Support informed, risk-based decision-making and compliant credentialing practices.
- Serve as a resource and mentor to credentialing staff, including supporting training, onboarding, and professional development.
- Contribute to the development, interpretation, and maintenance of credentialing policies and procedures.
- Participate in audits and quality reviews.
- Lead or support process improvement initiatives to improve operational effectiveness, consistency, compliance, and continuous improvement.
- Demonstrate initiative in resolving issues, addressing concerns, identifying potential risks, and improving processes and outcomes.
- Communicate clearly and professionally, listen actively, seek clarification when needed, and respond promptly to requests for information.
- Align work and results with IU Health’s mission, vision, values, and strategic direction.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
