Analyst I - Provider Credentialing - QC Analyst - Apidel Technologies

Description:
Screening Questions:

Notate city/state at top of resume
1. Excel is required - what experience do they have using MS Excel
2. How familiar are they with creating formulas within Excel
3. Explain how they use data mining
4. Are they comfortable working during EST time zone
Health is seeking an analyst experienced in health care or health plan compliance monitoring and auditing to join our Credentialing and Payer Delegation team. This position supports the credentialing compliance monitoring program activities, auditing, data collection, trend analysis and meeting timeliness for delegated payer deliverables.
Participates in the development and ongoing implementation of quality improvement activities. Improve quality products and services, by using measurements and analysis to process, evaluate and make recommendations to meet QM compliance objectives
Conducting ongoing monitoring to evaluate levels of regulatory credentialing and delegated payer compliance with contractual and requirements
Performing credentialing business process functions as needed, and credentialing documentation audits
Assist with credentialing tasks as needed
Reviewing risk assessments while participating in ongoing monitoring and annual identification of areas where there can be process improvement
Building and maintaining effective, positive internal and external customer relationships
Participating in team initiatives and projects and meeting deadlines and quality expectations
Exhibiting  Heart at Work Behaviors

Experience:
3%2B years of related health care or health plan experience in credentialing compliance,
auditing, and quality assurance
Proficient in Microsoft Office Applications; Excel, Outlook, Word, and Teams
The ability to create spreadsheets, analyze data and identify trends.
Strong attention to detail and the ability to multi-task in a fast-paced environment
MD Staff experience is preferred

Education:
Bachelors Degree

Duties
Participates in the development and ongoing implementation of quality improvement activities. Improve quality products and services, by using measurements and analysis to process, evaluate and make recommendations to meet QM compliance objectives
Conducting ongoing monitoring to evaluate levels of regulatory credentialing and delegated payer compliance with contractual and requirements
Performing credentialing business process functions as needed, and credentialing documentation audits
Assist with credentialing tasks as needed
Reviewing risk assessments while participating in ongoing monitoring and annual identification of areas where there can be process improvement
Building and maintaining effective, positive internal and external customer relationships
Participating in team initiatives and projects and meeting deadlines and quality expectations
Exhibiting  Heart at Work Behaviors

Experience
3%2B years of related health care or health plan experience in credentialing compliance,
auditing, and quality assurance
Proficient in Microsoft Office Applications; Excel, Outlook, Word, and Teams
The ability to create spreadsheets, analyze data and identify trends.
Strong attention to detail and the ability to multi-task in a fast-paced environment
MD Staff experience is preferred

Position Summary
Health is seeking an analyst experienced in health care or health plan compliance monitoring and auditing to join our Credentialing and Payer Delegation team. This position supports the credentialing compliance monitoring program activities, auditing, data collection, trend analysis and meeting timeliness for delegated payer deliverables.

Education
Minimum of a Bachelors Degree
What days & hours will the person work in this position List training hours, if different.
Mon-Fri 8:30a-5p EST