Accreditation Standards, Analysis Skills, Communication Skills, Content Management Systems (CMS), Data Quality, Database Report Tools, Detail Oriented, External Audit, Health Informatics, Healthcare Administration, Internal Audit, Leadership, Maintain Compliance, National Committee for Quality Assurance (NCQA), Onboarding, Patient Care, Performance Analysis, Performance Metrics, Physician Credential, Process Development, Process Improvement, Provider Credentialing, Regulatory Compliance, Reporting Dashboards, SQL (Structured Query Language), Tableau, Time Management
Position: Senior Analyst Physician Credentialing
Location: Remote
Duration: Long term contract
Note: Looking for Permanent / Visa Independent Consultants
Senior Analyst Physician Credentialing:
The Senior Analyst, Physician Credentialing, supports the integrity, efficiency, and compliance of the organization's credentialing and privileging processes. This role partners with credentialing teams, physician leadership, and compliance stakeholders to ensure accurate provider onboarding, recredentialing, and privileging while identifying opportunities to improve credentialing workflows. The position combines deep operational knowledge of physician credentialing with analytical capabilities to enhance turnaround times, ensure data integrity, and maintain regulatory compliance, ultimately supporting provider readiness and patient care delivery.
Job Qualifications / Education / Training / Certification / Licensure:
- Bachelor's degree in Healthcare Administration, Business, or related field, or equivalent experience in physician credentialing
- Minimum 3 5 years of experience in physician credentialing and privileging
- Experience with credentialing systems (e.g., MDStaff, symplr, or equivalent)
- Strong Experience with data/reporting tools (SQL, Tableau, or similar)
- Strong analytical mindset with ability to identify process improvement opportunities within credentialing workflows
- Excellent communication skills; ability to work effectively with physicians, administrators, and leadership
- High attention to detail with a focus on compliance, audit readiness, and data accuracy
- Knowledge of EPIC provider data (SER / Provider Master) or related systems is a plus
Job Responsibilities:
- Manage and support end-to-end physician credentialing and privileging processes, including initial appointments, reappointments, and expirables tracking
- Ensure compliance with regulatory and accreditation standards (TJC, NCQA, CMS) throughout credentialing lifecycle
- Maintain and validate provider data across credentialing systems and downstream platforms (e.g., EPIC, payor enrollment systems)
- Monitor key credentialing performance metrics, including:
- Credentialing turnaround times
- Application completeness and deficiency resolution
- Expirable tracking and compliance
- Identify operational bottlenecks and recommend process improvements to improve efficiency and reduce delays
- Develop and maintain credentialing reports and dashboards to support leadership visibility and decision-making
- Support internal audits, external surveys, and accreditation reviews
- Collaborate on provider onboarding to ensure timely activation and readiness
- Assist with standardization of credentialing policies and procedures across entities
- Document workflows and recommend technology/process enhancements
- Support onboarding of new providers or entities by ensuring accurate and complete credentialing data