Credentialing Specialist

WVP Health Authority | Part-Time | Less than 30 Hours per Week

WVP Health Authority is seeking an experienced Credentialing Specialist to support credentialing and recredentialing activities for our network of over 450 healthcare practitioners. This position is ideal for a credentialing professional who is highly organized, detail-oriented, knowledgeable about healthcare credentialing requirements, and able to independently manage credentialing files and deadlines.

The Credentialing Specialist is responsible for obtaining, verifying, maintaining, and monitoring practitioner credentialing information to support timely and compliant credentialing and recredentialing decisions.

About WVP Health Authority

WVP Health Authority is the Independent Provider Association supporting independent healthcare providers in Marion and Polk county in the Willamette Valley since 1976. WVP works collaboratively with providers and community partners to strengthen access to high-quality healthcare throughout the region. Our credentialing program supports a strong, compliant provider network while maintaining responsive and professional relationships with the practitioners and practices we serve.

Key Responsibilities

·      Manage initial credentialing and recredentialing files from application through completion.

·      Conduct and document required primary source verifications.

·      Review practitioner applications and supporting documentation for completeness, accuracy, and compliance.

·      Maintain accurate practitioner information within credentialing databases and tracking systems.

·      Monitor recredentialing schedules and ensure practitioners are processed within required timelines.

·      Identify missing, inconsistent, or expired information and conduct timely practitioner follow-up.

·      Maintain credentialing status reports and other compliance tracking tools.

·      Maintain familiarity with and apply applicable NCQA, CMS, NPDB, state licensing board, regulatory, and WVP credentialing requirements.

·      Support preparation of credentialing files for committee review and decision-making.

·      Assist with credentialing audits, file reviews, data integrity activities, and compliance monitoring.

·      Communicate professionally and effectively with practitioners, practice staff, internal departments, and external organizations.

·      Maintain strict confidentiality of practitioner and organizational information.

·      Perform other credentialing-related duties as assigned.

Required Qualifications

·      Healthcare credentialing experience required.

·      Demonstrated experience performing initial credentialing and/or recredentialing activities.

·      Working knowledge of primary source verification and healthcare credentialing documentation requirements.

·      Strong organizational skills with the ability to manage multiple files, deadlines, and follow-up activities simultaneously.

·      Strong attention to detail and commitment to accurate documentation.

·      Effective written and verbal communication skills.

·      Proficiency with Microsoft Office applications and experience working with credentialing databases or similar electronic systems.

·      High school diploma required.

Preferred Qualifications

·      Knowledge of NCQA credentialing standards and requirements.

·      Certified Provider Credentialing Specialist (CPCS) certification through NAMSS or similar professional credentialing certification.

·      Experience working with an IPA, health plan, provider network, CCO, healthcare organization, or delegated credentialing entity.

·      Experience supporting credentialing audits and regulatory or accreditation compliance.

Position Details

·      Part-time position - less than 30 hours per week.

·      Schedule may be structured based on departmental needs and candidate availability.

·      Position requires consistent attention to credentialing deadlines, regulatory requirements, and practitioner follow-up.

WVP Health Authority is an equal opportunity employer and values professionalism, collaboration, accountability, and service to our healthcare community.

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