Credentialing Specialist

Job not on LinkedIn

🕒 May 26

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Healthfirst

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1993

🛡️ Insurance

🏥 Healthcare

⚕️ Healthcare Insurance

Insurance • Healthcare • Healthcare Insurance

Healthfirst is a health insurance provider dedicated to helping New Yorkers access affordable health coverage for individuals and families. With over 30 years of experience, Healthfirst offers a range of plans including Medicaid managed care, Medicare Advantage, long-term care, and essential health plans. The company focuses on providing quality healthcare options, comprehensive benefits, and support to ensure members can maintain their health and well-being.

📋 Description

• Credentials providers, facilities, and vendors in accordance to regulations and Healthfirst policy. • Prepares presentations for the quarterly credentialing and delegate vendor oversight committee meetings. • Facilitates pre-delegation and delegation vendor audits to ensure adherence to contractual arrangements. • Prepares hard-copy directories and works with third party vendors for posting online directories. • Reviews relevant data to ensure accuracy. • Effectively communicates to internal departments and external partners. • Identifies and assesses opportunities to improve processes to better ensure regulatory compliance and adherence to state and federal regulations. • Raises issues to management and assists in resolution. • Additional duties as assigned.

🎯 Requirements

• HS diploma/GED • Bachelor’s degree (Preferred) • Prior relevant experience • Time and project management skills • Critical/creative thinking skills • Communication skills • Problem-solving skills • Intermediate Microsoft software skills (Adobe, Access, Excel, Word, PowerPoint, and Office)

🏖️ Benefits

• WE ARE AN EQUAL OPPORTUNITY EMPLOYER • If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798 .