Temporary Provider Services Credentialing Specialist

Job Description

Central California Alliance for Health is seeking a Temporary Provider Services Credentialing Specialist. This is a temporary position expected to last 3-6 months, with the selected candidate being employed by a temporary employment agency. The role reports to the Provider Services Credentialing Supervisor and involves conducting provider credentialing and re-credentialing, performing Primary Source Verifications, researching and analyzing complex credentialing issues, and monitoring physician license status and sanctions.Responsibilities:

• Conducting provider credentialing and re-credentialing, including performing Primary Source Verifications
• Researching and analyzing complex credentialing issues and develops and proposes solutions
• Performing ongoing monitoring of physician license status and state and federal sanctions of contracted and non-contracted providers and conducts related investigation

Requirements:

• Bachelor's degree in Business or Public Administration, Public Policy, Health Care or a related field
• Minimum of three years of experience performing credentialing, compliance or other regulatory functions in a healthcare or government setting (a Master’s degree may substitute for two years of the required experience)
• Knowledge of research, analysis, and reporting methods
• Knowledge of data entry and auditing techniques
• Knowledge of customer service principles
• Ability to interpret and apply policies, procedures, laws, and regulations
• Ability to identify and troubleshoot issues, analyze data, and recommend solutions
• Ability to enter, verify, and audit data

The role offers:

• Hybrid work environment with potential for remote work
• Opportunity to contribute to accessible, quality healthcare in Central California