Credential Delegation Analyst

Highmark Health

Base: $23.16 - $35.88; bonus/equity: not specified...
Ncqa regulatory standards knowledge
Ghp delegated credentialing program experience
Provider re-credentialing expertise
This role coordinates and maintains the delegated credentialing program in strict accordance with GHP, NCQA, and all regulatory agency standards

Job Summary

  • This role coordinates and maintains the delegated credentialing program in strict accordance with GHP, NCQA, and all regulatory agency standards.
  • The incumbent is responsible for conducting pre-delegation assessments, annual oversight audits, and ongoing monitoring of recommendations and work plans.
  • The position requires developing and monitoring corrective action plans to ensure all delegates meet contract standards and performance expectations.

Matching Summary

This role coordinates and maintains the delegated credentialing program in strict accordance with GHP, NCQA, and all regulatory agency standards.

Salary

Base: $23.16 - $35.88; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • NCQA regulatory standards knowledge
  • GHP delegated credentialing program experience
  • Provider re-credentialing expertise
  • Annual oversight audit coordination
  • Corrective action plan development

Nice-to-have

  • Strong problem resolution skills
  • Effective cross-department communication
  • Data analysis and reporting capabilities
  • Committee meeting participation experience

Key Requirements

  • High school diploma or GED required
  • 3 years healthcare/managed care experience
  • 3 years provider credentialing/re-credentialing experience
  • 3 years experience with NCQA and regulatory standards
  • Bachelor's degree preferred
  • CPCS certification preferred

Work Rights

Not specified

Tailored Resume

Cover Letter