Credentialing Analyst - UPMC Washington, WPHO

UPMC•Washington, PA

About The Position

We are seeking a highly organized and detail‑driven Credentialing Analyst to join our WPHO Services team. This role plays a vital part in ensuring our providers meet all regulatory, accreditation, and organizational standards. The ideal candidate will bring strong analytical skills, a commitment to accuracy, and the ability to manage complex credentialing processes in a fast‑paced healthcare environment. If you are passionate about supporting clinical excellence and maintaining the highest standards of patient safety, we invite you to apply.

Requirements

High school diploma or equivalent required.
Experience in credentialing preferred.
Excellent written/verbal communication skills.
Ability to gather and manipulate data accurately and consistently.
Strong organizational skills.
Ability to manage multiple task and be flexible to the daily needs of the organization.
Computer competence.
Attention to detail.
Act 34

Responsibilities

Provide support to Data Management including but not limited to: spreadsheet maintenance, license, degree and insurance product data query in contract and credentialing
Demonstrate knowledge of state, federal, and NCQA regulations concerning credentialing.
Complete provider complaint documentation.
Utilize Equifax, NPDB, and the federal cumulative sanction software for credentialing.
Initiate and maintain fluid communication with individual providers being credentialed.
Prioritize work assignments related to credentialing processes to ensure timely completion with satisfactory results.
Initiate consultation with the Chief Medical Officer or designee when provider specific information warrants, to include but not limited to NPDB queries, Act 33 & 34, claims histories, licensure, references.
Track expired data for providers and follow-up appropriately including state licensure, professional references, NPDB, etc.
Complete PsychConsult Network Credentialing Manager checklist for all practitioners assigned for review.
Enter provider data into PsychConsult Network Credentialing Manager and PSV Manager.