Credentialing Coordinator - BioPlus Specialty Pharmacy
Core
Coordinates and leads credentialing program-level compliance activities, including sanction monitoring, delegation oversight audits, and regulatory audits for specialty pharmacy providers.
Role type
Mid-level operational compliance coordinator
Builds
Maintains compliance standards and audit processes for contracted healthcare organizations
Domain
Healthcare administration / Specialty Pharmacy
Deliverable
dashboards & analysis
Required skills
Credentialing oversight, audit coordination, contract compliance monitoring, vendor liaison, policy review, issue resolution, process improvement
Preferred skills
Credentialing certification
Technologies
None explicitly stated
Responsibilities
Perform oversight of credentialing and re-credentialing activities and processes, including internal and external audits; Act as a liaison to delegates and credentialing vendors to ensure compliance; Monitor contract compliance and coordinate contractual language changes; Coordinate all compliance filings of credentialing specific documents and policies; Conduct initial, annual, and focused audits; Resolve issues specific to delegation oversight, sanction monitoring, and system configuration; Serve as corporate contact for regulatory or accreditation audits; Provide process oversight for resolution of non-responsive providers; Research and resolve delegated credentialing-related issues.