Senior Analyst, Credentialing Quality & Data Operations
Core
Ensures accuracy, quality, and compliance of healthcare provider credentialing and operational data through audits, analytics, and process improvements.
Role type
Senior Analyst (Healthcare Operations & Data Quality)
Builds
Operational dashboards, audit reports, and data-driven corrective action plans for provider credentialing workflows.
Domain
Healthcare Insurance / Provider Credentialing / Data Operations
Deliverable
dashboards & analysis
Required skills
Healthcare credentialing audits, root-cause analysis, data reconciliation, regulatory compliance knowledge, report building, project management
Preferred skills
SQL, BigQuery, BI platforms, audit management systems, NCQA/CMS regulatory knowledge
Technologies
Excel, Google Sheets, SQL, BigQuery, BI platforms, audit management systems
Responsibilities
Conduct risk-based quality audits on practitioner and facility credentialing records; analyze complex datasets to measure operational performance; build and validate reports and dashboards; perform root-cause analysis to drive process improvements; manage projects and caseloads independently; coach team members on credentialing standards.
Seniority
Senior, hands-on IC
