NEW JOB OPENING
REMOTE CREDENTIALING COMPLIANCE ANALYST
IN Remote, USA!

Required Education

• High School Diploma or Equivalent



Preferred Education:

• Bachelor's Degree



Required Qualifications/Skills/Experience:

• 3+ years of healthcare or health plan experience in credentialing compliance, auditing, quality assurance, or related compliance functions

• Proficiency in Microsoft Excel, Outlook, Word, and Teams

• Experience creating spreadsheets, developing formulas, analyzing data, and identifying trends

• Experience conducting credentialing documentation reviews and audits

• Strong understanding of compliance monitoring, quality improvement, and regulatory requirements

• Excellent analytical, organizational, and problem-solving skills

• Strong attention to detail with the ability to manage multiple priorities in a fast-paced environment

• Ability to work independently with minimal supervision

• Strong verbal and written communication skills

• Reliable internet connection and dedicated remote workspace



Preferred Qualifications/Skills/Experience:

• Experience with MDStaff

• Experience supporting payer delegation programs

• Experience performing risk assessments and compliance monitoring activities

• Experience developing reports, dashboards, and trend analysis for leadership



Remote Credentialing Compliance Analyst Overview:

• This position supports credentialing compliance monitoring, auditing, quality assurance, and payer delegation activities within a healthcare environment

• The Analyst is responsible for monitoring compliance with contractual, regulatory, and program requirements while supporting credentialing quality management initiatives

• The role involves collecting and analyzing data, identifying trends, creating reports, conducting audits, reviewing risk assessments, and assisting with quality improvement initiatives

• The Analyst will work closely with internal and external stakeholders to support compliance monitoring activities, ensure timely completion of deliverables, and maintain effective working relationships

• Success in this role requires strong analytical abilities, advanced Excel skills, attention to detail, and the ability to manage multiple projects simultaneously

• The ideal candidate will have experience in healthcare credentialing compliance, auditing, and quality assurance, along with the ability to work independently in a fully remote environment while meeting established deadlines and quality expectations



Job Duties:

• Assist with credentialing compliance monitoring and payer delegation activities

• Prepare deliverables for internal and external audit requests

• Support credentialing-related business processes and tasks

• Conduct ongoing monitoring of regulatory, contractual, and delegated payer compliance requirements

• Perform credentialing documentation reviews and audits

• Create spreadsheets, reports, and data analysis tools to track compliance metrics and trends

• Analyze data and identify opportunities for process improvement

• Participate in quality improvement initiatives and program evaluations

• Review risk assessments and support ongoing monitoring activities

• Build and maintain positive relationships with internal and external stakeholders

• Present findings and recommendations in a clear and professional manner

• Manage multiple projects while meeting deadlines and quality expectations

• Maintain working knowledge of contractual, regulatory, and program policy requirements



Dress Code:

• Business Casual for virtual meetings

• **Only those lawfully authorized to work in the designated country associated with the position will be considered.**

• **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**