Health Specialist Jobs

About The Position

Requirements

• High school diploma required.
• Minimum 3 years of credentialing experience in a hospital or integrated healthcare system.
• Experience with credentialing software database systems.
• Demonstrated ability to analyze complex information, exercise sound judgment, and manage competing priorities.
• Strong knowledge of Joint Commission, CMS, and NCQA standards.
• Excellent communication and training skills, including the ability to provide constructive feedback.

Nice To Haves

• Associate's or Bachelor's degree in Business, Finance, Healthcare, or a related field.
• CPCS or CPMSM certification.

Responsibilities

• Conduct comprehensive initial and recredentialing primary-source verification of education, clinical training, licensure, work history, affiliations, malpractice claims, peer references, and other required elements.
• Investigate and resolve discrepancies and adverse or concerning findings, analyze their context and significance, and escalate significant or unresolved concerns according to policy.
• Prepare clear, objective summaries and support defensible recommendations for clinical leadership, Credentials Committees, the Medical Executive Committee, and governing committees.
• Evaluate clinical privileging requests against established criteria, including training, experience, current competence, eligibility requirements, specialized certifications, case volume, and supporting documentation.
• Route audited credentialing files electronically to Department Chiefs, Chairs, or designees for review and recommendations.
• Manage credentialing workflows in compliance with Joint Commission, CMS, and NCQA standards and required timelines; track applications through final Board action and address or escalate delays.
• Coordinate practitioner files through Credentials Committee, Medical Executive Committee, and Governing Board review and approval stages, documenting actions accurately.
• Complete post-approval actions, including updating credentialing systems, preparing and distributing Board approval communications, and coordinating EMR access and clinical activation with IT and operational teams.
• Guide practitioners through credentialing and privileging requirements, assist with document collection, provide status updates, and address questions or barriers to help prevent delays.
• Collaborate with clinical departments, HR, legal, licensing boards, malpractice carriers, and other stakeholders to exchange information and resolve issues affecting credentialing decisions.
• Coordinate day-to-day Medical Staff Office activities, including communications, scheduling, document preparation, and responding to routine inquiries.
• Manage productivity and quality metrics, monitor workflows and outcomes, identify trends and improvement opportunities, and support standardization and continuous improvement initiatives.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Prescription coverage
• Life and AD&D insurance
• Short-term and long-term disability insurance
• 403(b) retirement plan with employer match and additional non-elective contribution
• PTO and paid sick leave
• Tuition assistance, advancement support, and academic advising
• Parental, adoption, and surrogacy leave
• Backup and on-site childcare
• Well-being rewards
• Employee Assistance Program
• Fertility benefits and healthy pregnancy program
• Flexible spending and commuter accounts
• Pet, home, auto, identity theft, and legal insurance