Credentialing Data Analyst - SHP Health Services - Telecommuter - Day Shift - Full Time
Tasks
- Conduct annual review of delegate credentialing policies and procedures
- Coordinate credentialing delegation functions
- Develop and maintain credentialing and peer review policies
- Develop database queries and reporting
- Maintain credentialing documentation in electronic format
- Maintain provider database data integrity
- Monitor corrective action plan compliance
- Participate in ICE workgroups related to credentialing
- Perform credentialing audits for delegated entities
- Prepare clean file and unclean file reviews
- Prepare peer review committee summaries
- Provide consultation on guidelines policies procedures and protocols
- Validate statistical reports and regulatory filings
Perks/Benefits
- N/A
Skills/Tech-stack
CMS Compliance | Compliance reporting | Continuous quality | Continuous quality improvement | Credentialing Audits | Customer Service | Data Extracts | Data Integrity | Data Validation | Database Administration | Database querying | Managed care | NCQA standards | Peer review | Quality Improvement | Regulatory Compliance | Relational Database | SQL | Statistical Reporting
Education
Bachelor of Engineering | Bachelor of Science | Bachelor of Science in Business | Bachelor of Science in Healthcare Management
Roles
Regions
Countries
States
Cities
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