In this key hybrid role, you will perform quantitative data analysis and oversee initial credentialing and re-credentialing processes for Nurse Practitioners, Physician Assistants, Behavioral Health Providers, and Physicians. Working a standard schedule (Monday through Friday, 8:00 AM – 4:30 PM EST), you will ensure compliance with Joint Commission, NCQA, and URAC standards. Your daily responsibilities will include managing Epic system access for providers with out-of-compliance credentials, performing primary source verifications, conducting sanctions and compliance monitoring, and updating provider database grids. If you bring at least three years of healthcare credentialing experience, strong proficiency in MDStaff and MS Excel, and sharp critical thinking skills, this position offers an engaging platform to showcase your expertise.
salary: $24.99 - $25 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School
Responsibilities
Position Summary:
Conduct quantitative data analysis, manage initial credentialing and re-credentialing for medical providers, monitor expirable credentials, and ensure compliance with Joint Commission, NCQA, and URAC standards.
Key Responsibilities:
- Process initial credentialing and re-credentialing applications for NPs, PAs, Behavioral Health Providers, and MDs.
- Monitor expired licensure reporting, update credentialing databases, and manage Epic system access for non-compliant providers.
- Conduct sanctions and compliance monitoring, alerting leadership to any undisclosed negative findings.
- Maintain provider and physician SharePoint sites, credentialing grids, and support payer enrollment/audit activities.
- Perform primary source verifications and process malpractice insurance verification requests in accordance with internal policies.
- Minimum 3 years of healthcare industry experience in provider credentialing.
- In-depth understanding of Joint Commission Accreditation, NCQA, and URAC credentialing standards.
- Proficiency in quantitative analysis and credentialing software applications (MDStaff, MS Excel, MS Word, Outlook).
- strong critical thinking, organizational, and multi-tasking skills with effective verbal and written communication.
- Full availability for a hybrid work schedule based out of Cumberland, RI.
- Preferred: NAMSS Certified Professional Credentialing Specialist (CPCS) certification.
Skills
Qualifications
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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.