Credential Delegation Analyst

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Coordinate and uphold the designated credentialing program in line with GHP, NCQA, and regulatory agency standards.

• Maintain policies, procedures, and compliance documentation related to the delegation program.

• Coordinate, conduct, and assess pre-delegation evaluations and annual oversight audits.

• Monitor recommendations and action plans.

• Coordinate and uphold delegation agreements.

• Implement GHP programs effectively.

• Facilitate the resolution of issues.

• Provide daily supervision of credentialing delegates.

• Establish and execute monitoring processes to assess performance against contractual standards and expectations.

• Identify opportunities for improvement and barriers to success.

• Develop and oversee corrective action plans for delegates.

• Prepare evaluation reports detailing delegate performance, issues, deficiencies, and recommendations.

• Develop communication strategies with other GHP departments.

• Ensure that necessary data is collected and submitted accurately.

• Analyze reports for timeliness and accuracy.

• Design and generate reports based on specific requests.

• Attend delegation and GHP Committee meetings, along with relevant external meetings.

• Perform additional duties as assigned.

⛳️ Requirements

• High school diploma or GED is required.

• A minimum of 3 years of experience in healthcare or managed care is necessary.

• At least 3 years of experience in credentialing or re-credentialing practitioners or providers is required.

• A minimum of 3 years of experience with NCQA and other regulatory standards is essential.

• Ability to travel is required.

• A Bachelor's degree is preferred.

• Certification as a Provider Credentialing Specialist (CPCS) is preferred.

🏝️ Benefits

• Comprehensive health benefits.

• Opportunities for professional development and growth.

• Supportive work environment.

• Competitive salary and compensation package.