Credentialing Analyst

Our Client, a Retail Pharmacy company, is looking for a Credentialing Analyst for their Remote location.

• Assists in the preparation of deliverables for payer and internal audit requests
• Assist with credentialing tasks as needed
• Building and maintaining effective, positive internal and external customer relationships
• Conducting ongoing monitoring to evaluate levels of regulatory credentialing and delegated payer compliance with contractual and requirements
• Exhibiting Client Heart at Work Behaviors
• Participating in team initiatives and projects and meeting deadlines and quality expectations
• 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
• Performing credentialing business process functions as needed, performing scheduled and random credentialing file audits
• Reviewing risk assessments while participating in ongoing monitoring and annual program evaluation and identification of areas where there can be process improvement

• 3+ 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
• 2 years’ experience with NCQA compliance
• 1 year MD Staff experience.
• Bachelor’s Degree (preferred)
• Verifiable high school diploma or GED required

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.