Role Description Performs day-to-day activities to analyze primary source verification of licensure, education, training, professional references, and experience of applicants for medical staff or Allied Health membership. - Prepares and sends primary source verification requests. - Reviews received primary source verification and follows up as necessary. - Reviews new applications to ensure no data is missing and enters any new information into Credentialing Verification database. - Generates re-application reports and corresponds with affiliates to initiate the re-application process. - Regularly performs more complex Credentialing Verification functions. Qualifications - HS Diploma or General Education Diploma (GED) - 1 year recent relevant experience. - Knowledge of computer systems and their software applications, including Microsoft Word and Excel. - Interpersonal skills necessary to represent the organization in a professional and positive manner. - Ability to handle complex organizational arrangements, documentation, and requests from multiple committees and/or individuals. - Ability to organize, prioritize, carry out assignments, and problem solve with minimal supervision. - Ability to communicate ideas both verbally and in writing and listening skills. Requirements - Job Shift: Days - Schedule: Full Time - Shift Hours: 8 - Days of the Week: Monday - Friday - Weekend Requirements: None - Position Status: Non-Exempt - Weekly Hours: 40 - Employee Status: Regular Benefits - Comprehensive benefits package. Company Description Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $29.52 to $41.33 / hour. California Pay Range is $29.52 to $41.33 / hour. Utah Pay Range is $23.62 to $33.07 / hour. The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program.

Role Description UPMC Revenue Cycle is hiring Credentialing Coordinators to join our team. As a Credentialing Coordinator, you will be responsible for processing applications and performing primary source verification for applicants to the facilities and organizations of UPMC. You will process applications and perform primary source verification for reappointment and re-credentialing for practitioners who are members of UPMC facilities and organizations. - Perform data entry and scans accurately and efficiently according to established policies, procedures and guidelines. - Complete files efficiently, according to policy and within the established standards and guidelines. - Maintain excellent communication (verbal, written and electronic) with all customers of the CVO including, but not limited to, the practitioners and the entity users. - Process applications expeditiously and efficiently according to the established priorities and timeframes. - Perform primary source verification, record information received and provide follow up as necessary according to established policies and procedures. - Assist with database integrity and maintenance. Qualifications - High School Diploma or Equivalent and 2 years work experience required. - Excellent data entry and computer software application skills required and must have a desire to maximize the use of technology to automate processes. - Detail-oriented person with excellent communication and interpersonal skills required. - Prior credentialing experience preferred. - Experience with provider enrollment and credentialing preferred. - Experience with both JCAHO and NCQA standards preferred. Requirements - Licensure, Certifications, and Clearances: Act 34. Company Description UPMC is an Equal Opportunity Employer/Disability/Veteran.

• Manage end-to-end credentialing for providers from intake through approval • Build and maintain provider profiles in Modio • Track credentialing workflows and progress in JIRA • Perform primary source verification, including licenses, education, board certifications, DEA, and other required credentials • Conduct sanction screenings (OIG, SAM, NPDB) and complete compliance reviews • Partner cross-functionally to move providers from Credentialing Approved to Clear to Practice (CTP) • Communicate with providers to ensure timely completion of credentialing applications and required documentation • Maintain accurate credentialing records and support compliance requirements

Role Description The Credentialing Coordinator I is responsible for the processing, reviewing, and maintaining provider and facility credentialing and re-credentialing files within department turnaround and quality standards. He/she is responsible for working with the management team to monitor compliance of current workflows, assisting with defining revised workflows, and for distributing the day's assignments in the absence of the manager. - Enters and updates provider and facility data in credentialing database, PEP, and QNXT while still adhering to input standards, including for the OneCare and SCO lines of business. - Works with External Credentialing Verification Organization (CVO) on processing Credentialing Information and Reporting, as well as Delegate Credentialing information. - Maintains required ongoing monitoring and sanctions reporting. - Coordinates the processing of initial and re-credentialing applications within the established turnaround times while ensuring that Mass General Brigham Health Plan meets all State and NCQA requirements through the HCAS (HealthCare Administrative Solution) streamlined credentialing process. - Conducts verification of credentialing elements completed by CVO (i.e., license, DEA, board certification, and NPDB) through the use of system resources, and documents the status in the credentialing database and PEP. - Performs review and analysis of provider and facility credentialing and re-credentialing applications to determine completeness, including notifying providers when their applications are incomplete or missing information. - Provides representation, assistance, and guidance on the credentialing process during committee meetings. - Meets or exceeds all department quality standards for all initial and re-credentialing files. - In the absence of the manager, interacts and responds to inquiries from teammates with specific questions. - Holds self and others accountable to meet commitments. - Persists in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise. - Builds strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization. Qualifications - Education: Associate's Degree preferred - Experience: - At least 1-2 years of experience in Clinical/Medical Office/Healthcare required - At least 2-3 years of previous credentialing experience, with at least 1 year in a health insurance environment, highly preferred - Experience with OneCare and/or SCO highly preferred - Knowledge, Skills, and Abilities: - Knowledge of medical provider credentialing and accreditation principles, policies, processes, procedures, and documentation. - Competence in Microsoft Office including Outlook, Excel, and Word. - Ability to use independent judgment and to manage and impart confidential information. - Skill in establishing priorities with independent coordination of day-to-day aspects. - Ability to communicate effectively both orally and in writing. - Information research skills. - Ability to handle multiple tasks. Requirements - This is a remote role that can be done from most US states. - This is a full-time Eastern Standard schedule (e.g. 8-4:30 pm or 8:30-5:00 pm ET). - Remote workdays require a stable, secure, quiet, and compliant workspace. - Scheduled Weekly Hours: 40 - Employee Type: Regular - Work Shift: Day (United States of America) - Pay Range: $17.71 - $25.28/Hourly - Grade: 2 Benefits - Competitive salaries and a benefits package with flexible work options. - Career growth opportunities. - Recognition programs designed to celebrate your contributions and support your professional growth.