Credentialing & QI Reporting Specialist
About The Position
The primary responsibility of the Credentialing & QI Reporting Specialist is to support the agency’s compliance, credentialing, and quality improvement functions. This position facilitates the timely credentialing of applicable staff with Coordinated Care Organizations (CCOs) and private panels while also supporting Quality Improvement (QI) initiatives through data tracking, reporting, and compliance monitoring. This role works collaboratively with clinical and administrative staff to ensure accurate documentation, reporting compliance, and adherence to Oregon Administrative Rules (OAR) and contractual requirements. The position also supports the agency’s Measurable Outcomes Tracking System (MOTS) reporting and provides training and technical assistance related to the Electronic Client Record (ECR) system.
Requirements
- A minimum of a high school diploma or equivalent education is required.
- Proficiency in Microsoft Office 365 (Outlook, Word, Excel, PowerPoint, SharePoint, and OneDrive) and internet usage is required.
- Must have reliable transportation, a valid driver’s license, and automobile insurance which meets Options’ requirements.
- Must possess strong verbal and written communication skills, including technical writing abilities.
- Will be required to learn and effectively utilize the Electronic Client Record (ECR) system.
- Ability to safeguard protected health information and maintain confidentiality
- Strong attention to detail and accuracy
- Ability to work independently and manage multiple priorities
- Ability to meet deadlines and produce high-quality work
- Strong organizational and problem-solving skills
Nice To Haves
- At least three years of office/administrative experience or an equivalent combination of education and experience is preferred.
- Experience in a community mental health or behavioral health setting
Responsibilities
- Facilitate credentialing of new hires with all eligible provider panels
- Manage re-credentialing for applicable staff with Coordinated Care Organizations (CCOs) and private panels
- Initiate and support applications for new private panels
- Verify degrees, licenses, certifications, exclusions, and accreditations for credentialed staff
- Maintain staff credentialing records within the Electronic Client Record (ECR) system
- Maintain and update the Credentialing Panel Roster
- Assist staff with CAQH, NPPES, and DMAP enrollment
- Participate in private panel committee meetings and teleconferences
- Generate and maintain monthly QI and MOTS reports
- Ensure timely completion, accuracy, and submission of MOTS documentation to the Oregon Health Authority (OHA)
- Review, correct, and follow up on reporting errors identified internally or by OHA
- Analyze and interpret data to support quality improvement initiatives
- Ensure compliance with Oregon Administrative Rules and contractual requirements
- Assist with monitoring and implementation of the agency’s Quality Improvement Plan
- Support audits and compliance reviews as directed
- Provide training and technical assistance to staff on ECR usage and documentation compliance
- Collaborate with clinical and administrative teams to improve data accuracy and workflows
- Support staff in meeting documentation and reporting expectations
- Assist with maintaining documentation of QI activities for agency records
- Provide backup support to related administrative or records functions, as needed
Benefits
- company-paid health/vision and dental
- long-term disability
- life insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
