Department Analyst I - Credentialing

Cleveland Clinic

5d•Remote

About The Position

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One. Job Details Join the Cleveland Clinic team where you will work alongside passionate caregivers and make a lasting, meaningful impact on patient care. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world. At Cleveland Clinic, everyone is considered a caregiver, whether serving in a healthcare, customer service, administrative, or analytic role. As a Department Analyst, your caregiving begins in the office, where you will analyze and evaluate operational resources, data collection processes, services, programs, systems, budgets, and departmental procedures. In this role, you will also manage credentialing for Cleveland Clinic Foundation (CCF) providers, the largest provider group within the credentialing team, consisting of approximately 6,500 providers, ensuring they meet all health plan credentialing requirements and are accurately represented on delegated credentialing rosters. This position involves high-volume work with strict deadlines and rapid turnaround times following credentialing committee approvals. A caregiver in this role works remotely from 8:00 a.m. -- 5:00 p.m. or 7:00 a.m. – 4:00 p.m. To be considered for this position, you must reside locally and may be required to report to the West Creek facility on an occasional basis for meetings.

Requirements

Bachelor’s Degree in Business, Healthcare Administration or a related field and one year of statistical analysis experience or five years of relevant experience in a health care setting OR High School Diploma/GED and five years of experience OR Associate's Degree and three years of experience OR Master's Degree
Two years of commercial health plan credentialing experience OR medical staff office credentialing experience
Ability to perform work in a stationary position for extended periods
Ability to operate a computer and other office equipment
Ability to communicate and exchange accurate information
Follows standard precautions using personal protective equipment as required.

Nice To Haves

Excel proficiency: (filtering, sorting, find/replace, navigating large rosters)
Understanding of credentialing criteria for health plans
Knowledge of delegated credentialing vs. manual enrollment
Knowledge of primary source verification processes
Comfortable working in a fast-paced environment with large data sets
Experience with credentialing processes and compliance standards

Responsibilities

Analyze and evaluate operational and financial functions of administrative and operational units.
Analyze departmental resources, services, systems, budgets and programs.
Prepare and develop special reports and recommendations based on analysis.
Conduct basic statistical analysis and evaluation of unit services and performance.
Identify program or service strengths, weaknesses, and financial impact.
Identify opportunities for service and program improvement.
Assist with the development of operational plans, procedures and systems.
Review and evaluate current procedures and systems and develop recommendations for improvement.
Maintain awareness of and comply with various regulatory guidelines (JCAHO, FDA, HIPAA, OSHA, etc.).
Manage credentialing for CCF providers across multiple commercial health plans.
Ensure compliance with health plan credentialing criteria and delegated credentialing standards.
Perform primary source verification for licensure and credentials.
Maintain and update large provider rosters in Excel.
Meet tight deadlines (36–48 hours post-committee approval) for releasing providers to health plans.
Coordinate with internal teams to ensure accurate and timely credentialing