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compliance audits credentialing regulatory changes ncqa📋 Description
- Manage end-to-end delegated credentialing across a portfolio of payors.
- Serve as primary contact for delegated payor relationships.
- Lead pre-delegation audits, ongoing compliance, and annual audits.
- Develop audit-ready credentialing files with verification docs.
- Build and deliver reporting packages for delegated entities and payors.
- Coordinate with enrollment, partnerships, RCM, legal and compliance to keep data current.
🎯 Requirements
- 2-5 years enrollment/credentialing experience.
- At least 2 years in delegated credentialing.
- Working knowledge of NCQA credentialing standards.
- Experience preparing for delegated credentialing audits.
- Ability to manage multiple payor relationships and deadlines.
- Strong documentation and attention to detail.
🎁 Benefits
- Comprehensive health coverage: medical, dental, vision.
- Parental leave up to 18 weeks and family support.
- 401(k) plan with equity opportunities.
- Home office stipend and meals funds.
- Flexible PTO, 12 holidays, winter break.
- Mental health: therapy access and wellness apps.
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