Senior Analyst, Credentialing Quality & Data Operations

This is a fully remote position, open to applicants in Arizona, +5 more states.

📋 Description

• Execute intricate operational tasks across credentialing, provider data, quality assurance, and analytics.

• Assess practitioner and facility credentialing documentation, workflows, source materials, and system information for accuracy, completeness, timeliness, consistency, and compliance.

• Plan and conduct risk-based or routine quality audits; select samples, document evidence, score outcomes, identify error trends, and communicate findings.

• Analyze complex datasets utilizing spreadsheets, reporting tools, database queries, or other analytical techniques.

• Create, maintain, and validate reports, dashboards, metrics, and monitoring controls.

• Investigate data discrepancies and reconcile information across trusted sources.

• Conduct root-cause analysis and translate audit findings, data trends, and operational insights into corrective and preventive measures, process enhancements, and recommendations.

• Act as a credentialing resource on practitioner and facility requirements, including initial credentialing, recredentialing, verification, file review, committee preparation, delegated activities, and provider data dependencies.

• Assist in resolving complex quality, data, or credentialing issues; monitor action plans until completion and validate corrective measures.

• Mentor team members and provide subject-matter expertise.

• Independently manage assigned projects, analyses, audits, escalations, and caseloads.

• Report to the Senior Manager of Provider Operations Credentialing.

• Execute other duties as assigned.

⛳️ Requirements

• More than 3 years of relevant experience in healthcare operations, credentialing, quality assurance or audit, provider data, data analysis, or a related field.

• At least 1 year of experience in identifying risks or data issues, performing root-cause analysis, and driving initiatives to resolution.

• Intermediate proficiency in Excel or Google Sheets, including data validation, reconciliation, analysis, and clear presentation of findings.

• Experience in conducting healthcare credentialing quality audits, documentation, and follow-up on corrective actions.

• Skilled in analyzing operational datasets and creating reports or dashboards.

• Ability to grasp credentialing concepts and data.

• Knowledge of practitioner and facility credentialing, including primary-source verification and regulatory requirements.

• Must reside in the U.S., excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. Territories.

🏝️ Benefits

• Employee benefits.

• Unlimited vacation program.

• Annual performance bonuses.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 11 paid holidays.

• Paid sick time.

• Paid parental leave.

• 401(k) plan participation.

• Life insurance.

• Disability insurance.

• Paid wellness time.

• Wellness reimbursements.

• Occasional travel for team meetings and company events.