Temporary Senior Facility Credentialing Specialist

HF Management Services • New York City, LA

5d

About The Position

The Healthfirst Credentialing department credentials and re-credentials providers, facilities, and vendors in accordance with regulations and Healthfirst policy. The Senior Facility Credentialing Specialist reviews network provider data for accuracy and ensures compliance with regulatory requirements and federal and state regulations. The role prepares presentations for quarterly credentialing and delegate vendor oversight committee meetings; facilitates pre-delegation and delegation vendor audits to ensure adherence to contractual arrangements; and prepares hard-copy directories while coordinating with third-party vendors to post online directories. The specialist communicates with internal departments and external partners, identifies opportunities to improve processes and regulatory compliance, raises issues to management, and assists with resolution. Additional duties may be assigned.

Requirements

• High school diploma or GED.
• Facility credentialing experience or knowledge.
• Time and project management skills.
• Critical and creative thinking skills.
• Communication skills.
• Problem-solving skills.
• Intermediate Microsoft software skills, including Adobe, Access, Excel, Word, PowerPoint, and Office.

Nice To Haves

• Bachelor’s degree.
• Prior relevant experience.

Responsibilities

• Credential and re-credential providers, facilities, and vendors in accordance with regulations and Healthfirst policy.
• Review relevant network provider data for accuracy and regulatory compliance.
• Prepare presentations for quarterly credentialing and delegate vendor oversight committee meetings.
• Facilitate pre-delegation and delegation vendor audits to ensure adherence to contractual arrangements.
• Prepare hard-copy directories and work with third-party vendors to post online directories.
• Communicate effectively with internal departments and external partners.
• Identify and assess opportunities to improve processes and ensure regulatory compliance and adherence to state and federal regulations.
• Raise issues to management and assist in their resolution.
• Perform additional duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED