Credentialing Consultant

About Atrium:

What you do matters. As a people-centric organization, we foster an environment of collaboration, high performance, and innovation where your talents are valued, and your achievements are celebrated. Join us and become part of an inclusive team.

Client Overview:

Join an innovative, rapidly growing company dedicated to delivering exceptional healthcare solutions. This company is seeking an experienced Credentialing Consultant to enhance their credentialing processes and ensure compliance with industry standards.

Salary/Hourly Rate:

$40/hr

Position Overview:

The Credentialing Consultant will play a crucial role in reviewing and refining the policies and procedures. This position is essential for developing a robust quality assurance process for provider rosters and data, ensuring consistency across the credentialing team, and maximizing the effectiveness of the credentialing tool. The Credentialing Consultant will ensure compliance with industry standards on a contract basis.

Responsibilities of the Credentialing Consultant:

• Reviewing current credentialing policies, procedures, and workflows.
• The Credentialing Consultant will be developing a solid QA process for Provider Rosters and data.
• Ensuring consistent processes across all credentialing team members.
• Maximizing productivity with the credentialing tool.

Qualifications for the Credentialing Consultant:

• The Credentialing Consultant must have a minimum of 7 years of experience in a quality-focused healthcare role, with extensive expertise in provider credentialing and data integrity.
• Proven track record in managing provider network adequacy within a health plan setting.
• The Credentialing Consultant must have experience in developing comprehensive policy and procedure documentation.
• In-depth knowledge of NCQA Accreditation requirements, with hands-on experience in preparing for and leading accreditation efforts.
• Familiarity with Salesforce and Verifiable is strongly preferred.

Education Requirements:

• Bachelor’s degree is required.

Benefits:

• Atrium Care Package available, upon eligibility (including healthcare plans, discount programs, and paid time off).