Network Provide Credentialing Coordinator

Description

JOB PURPOSE:

The Network Provider Credentialing Coordinator reports directly to Operations Manager II and is responsible for coordinating the comprehensive credentialing onboarding and ongoing maintenance of Endeavors participating network providers. Serving as the primary administrative resource for provider credentialing activities this position provides operational and administrative support across provider enrollment data integrity compliance verification and day-to-day network support. The coordinator establishes and maintains standardized workflows tracking systems and quality monitoring processes to ensure all participating providers strictly meet organizational and regulatory standards. Working cross-functionally with Provider Networks Finance Quality Clinical Leadership and Client Access teams this role proactively identifies operational bottlenecks maintains accurate provider records and optimizes network effectiveness in alignment with organizational goals.

ESSENTIAL JOB RESPONSIBILITIES:

Coordinate end-to-end initial credentialing re-credentialing and re-appointment processes for participating network providers.
Perform rigorous primary source verification and collect review and maintain all required documentation including professional licenses certifications registrations malpractice insurance curriculum vitae and background checks strictly adhering to organizational policies accreditation standards and regulatory requirements.
Maintain comprehensive highly organized audit-ready credentialing files and electronic databases.
Proactively monitor credential expiration dates manage ongoing maintenance tracking coordinate provider attestations and prepare meticulously detailed credentialing packets for executive review and committee approval.
Enter approved and credentialed providers into the enterprise system of record ensuring all system data is maintained with high accuracy and up-to-date information.
Oversee the end-to-end onboarding lifecycle for newly approved network providers.
Ensure the timely completion of all onboarding documentation coordinate structured provider orientations and required training facilitate cross-departmental alignment and utilize tracking checklists to monitor milestone completions.
Provide robust administrative leadership for the Network Provider Program.
Coordinate meeting logistics agendas and minutes and maintain dynamic provider directories and accurate contact databases.
Support the preparation of performance dashboards program metrics and departmental reports and manage standardized templates forms and administrative assets.
Serve as the primary professional point of contact for participating network providers regarding credentialing onboarding and program requirements.
Cultivate positive collaborative working relationships promptly resolve or escalate complex provider inquiries and ensure seamless communication channels between external providers and internal departments.
Ensure all credentialing and network operations strictly comply with internal policies contractual specifications accreditation guidelines and state and federal regulations while maintaining the highest standards of data confidentiality.
Act as a key functional resource during internal and external audits accreditation surveys and compliance reviews.
Proactively identify operational bottlenecks and participate in cross-functional quality improvement initiatives.
Perform other duties as assigned.
Demonstrate Exceptional customer service in Everything you do by placing the child family Veteran or client first to support our mission to Empower people to build better lives for themselves their families and their communities.

ESSENTIAL QUALIFICATIONS:

EDUCATION : Associates degree in Healthcare Administration Business Administration or a related field required; equivalent experience may be considered. Bachelors degree preferred.

EXPERIENCE: Minimum two years of healthcare administrative experience required. Experience coordinating provider credentialing provider enrollment medical staff services or healthcare administration preferred. Credentialing experience with provider networks managed care organizations hospitals or medical groups along with experience using credentialing software CAQH NPPES PECOS or provider database systems preferred. Familiarity with NCQA CMS Joint Commission CARF or other healthcare accreditation standards a plus.

ATTENDANCE: Must maintain regular and acceptable attendance at such level as is determined in the employers sole discretion.

LICENSES: Drivers License with clear record.

BACKGROUND CHECK: Must be able to pass a government background investigation.

VEHICLE: Must have daily use of a vehicle without prior notice.

OTHER: Must be available and willing to travel to various locations and with such frequency as the business need dictates.

Endeavors has a longstanding practice of providing a work environment that is free from all forms of employment discrimination including harassment because of race color sex gender age religion national origin marital status sexual orientation gender identity genetic information disability military or veteran status or any other characteristic protected by law. We recruit hire employ train promote and compensate individuals based on job-related qualifications and abilities.

Endeavors also provides reasonable accommodation to qualified individuals with disabilities or based on a sincerely held religious belief in accordance with applicable laws. If you need to inquire about an accommodation or need assistance with completing the application process please or speak with your recruiter.

Required Experience:

IC