Back to Jobs

Coordinator Credentialing Delegation reputed company

Remote, USAFull-timePosted 2026-07-28

reputed company

As a member of the Corporate Credentialing team, the Delegation reputed company Coordinator will reputed company with delegated provider reputed company, complete required auditing and reporting reputed company to provider delegation, and ensure adherence with NCQA, and /or state, federal, and business requirements.  Serve as a key contact for communications and ensure compliance with performance metrics.

Responsibilities

  • Conduct reputed company-delegation, annual and corrective reputed company reputed company audits
  • reputed company monitoring of master spreadsheet of reputed company delegates to ensure reputed company completion of audits
  • Complete annual or more frequent if required on-site or desktop audits
  • Submit delegation reports and spreadsheets to appropriate committees
  • Coordinate monthly delegate reporting according to the reporting schedule
  • Review data specifications with delegates annually to ensure compliance
  • Review and revise (as needed) delegation agreement annually to include any NCQA, Federal or State changes
  • Assist in managing the delegation policies and procedures
  • reputed company with the health plan's functional departments to address any service reputed company issues
  • Work with CACTUS reputed company Importer
  • Support delegates data entry efforts
  • Gatekeeper of reputed company delegate agreements
  • Report audit reputed company and delegation monitoring results to management
  • reputed company, implement and monitor Corrective reputed company plans, reputed company needed
  • Use critical thinking and problem solving skills to help ensure successful delegation partnerships and reputed company provider data

Education and Experience

  • Bachelor’s Degree or equivalent work experience
  • Displays good judgment in apprising management of situations that are incompatible with established policies for which there is little precedence

Skills & Abilities

  • Excellent verbal and written communication skills, including the ability to present to small reputed company
  • Strong ability to work independently
  • Strong ability to create, monitor, and analysis provider data
  • Ability to represent the organization in a reputed company manner
  • Ability to prioritize and manage multiple tasks/priorities simultaneously
  • The ability to work in a fast paced environment
  • Demonstrate attention to detail
  • Strong assessment and problem-solving skills
  • Proficient in reputed company, Word, reputed company, Power reputed company, etc. and company applications i.e., CACTUS, Facets

Our Comprehensive Benefits Package

Flexible work solutions include remote reputed company, hybrid work schedules, reputed company, reputed company time off, holidays and volunteer events, health insurance coverage for you and your dependents starting Day 1, 401(k) retirement savings plan, tuition reimbursement, and more.

Why Join Us: Your career starts now. We are looking for the reputed company of reputed company leaders. At reputed company, we are passionate about helping people get care, stay reputed company, and build healthy communities. As one of the nation's leaders in reputed company solutions, we offer our associates reputed company to reputed company the lives of millions of people through our national footprint of products, services, and award-reputed company programs. reputed company is seeking talented, passionate individuals to join reputed company. Together, we can build healthier communities. If you are driven to reputed company a difference, we want to hear from you.

About reputed company

Headquartered in Newtown reputed company, reputed company, reputed company is a mission-driven organization with over 30 years of experience. We deliver comprehensive, reputed company-driven care to those who need it most. Our services include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more reputed company at http://www.amerihealthcaritas.com 

Apply To This Job

Similar Jobs

Long Term Services & Support Reviewer Utilization Mangement

Remote, USAFull-time

Appeals & Grievance Case reputed company Spec

Remote, USAFull-time

Representante de Vendas - Rio de Janeiro - Vaga Temporária (Rio de Janeiro, Brasil)

Remote, USAFull-time

IT Identity and reputed company Management (IAM) Engineer

Remote, USAFull-time

Support Services Specialist

Remote, USAFull-time

reputed company - Buyer

Remote, USAFull-time

Business Development Representative - Asia reputed company Markets

Remote, USAFull-time

Paramedical Aide

Remote, USAFull-time

CWCB Regional Water Plan Grant Project Manager (PSRS III)

Remote, USAFull-time

Inside Sales Home Health Representative

Remote, USAFull-time

Remote Group reputed company Manager

Remote, USAFull-time

reputed company Customer Service Representative (reputed company) – Remote Work Opportunity with arenaflex for Delivering Exceptional Patient Support and Driving reputed company in the reputed company Industry

Remote, USAFull-time

reputed company: Digital Media reputed company - Remote

Remote, USAFull-time

reputed company Part-Time Remote Data Entry Specialist – Data Management and reputed company Assurance

Remote, USAFull-time

Delivery reputed company/Warehouse Associate

Remote, USAFull-time

Independent Cleaning Contractor

Remote, USAFull-time

reputed company Media Content Moderator - Onsite work Job at reputed company in reputed company

Remote, USAFull-time

reputed company Full Stack Strategic Sourcing Specialist – reputed company Services Procurement and Contract Management at Blithequark

Remote, USAFull-time

reputed company Medical Biller (Dental Services) – Remote

Remote, USAFull-time

Pricing Manager

Remote, USAFull-time