Senior Credentialing Specialist responsible for managing complex credentialing, enrollment, and regulatory maintenance for medical and allied health staff across multiple payors and jurisdictions.
Responsibilities
Prepare and complete credentialing data processes including applications and verifications
Manage complex credentialing and enrollment applications from receipt through completion
Analyze nonstandard requirements and resolve documentation discrepancies
Complete and validate CAQH, Cactus, paper and electronic applications
Manage high-risk or time-sensitive cases and communicate status to leadership
Requirements
High school diploma or GED
Associate degree in healthcare administration, business administration, health information management, or related field
Nice to have: Associate degree
Nice to have: CPCS (Certified Provider Credentialing Specialist)
An advanced-level specialist responsible for conducting and reviewing eligibility determinations across TANF, SNAP, and Medicaid programs, serving as a key program resource to fellow employees by providing policy guidance and technical support.
Responsibilities
Conduct initial and ongoing eligibility determinations for TANF, SNAP, and Medicaid, including highly complex cases requiring advanced program knowledge.
Serve as a program resource to fellow employees, providing guidance, answering policy questions, and helping staff navigate detailed public assistance regulations.
Monitor program trends, prepare seasonal and annual reports, and participate in quality improvement projects.
Engage in outreach, task forces, strategic planning, mentoring, and training activities to support agency goals.
Manage a caseload involving complex household circumstances, fluctuating income, multi-ownership situations, and evolving client needs.
Requirements
High school diploma supplemented with additional training and related work experience OR any equivalent combination of training and experience
Serve as the primary clinical authority for real-time clinician questions and escalations, support direct patient care, and contribute to clinical quality and safety initiatives.
Compensation
Compensation: $110/hour (W2)
Responsibilities
Serve as the primary clinical authority for real-time clinician questions and escalations
Support direct patient care, including escalated visits and DEA-required encounters
Review and manage time-sensitive patient cases, laboratory results, and clinical inbox items
Identify patterns, risks, and opportunities for improvement, and share insights with clinical leadership
Assistant Head Nurse (AHN) in the Sturgeon Community Hospital Emergency Department providing clinical and operational leadership to manage patient flow and support nursing staff.
Responsibilities
Co‑ordinate patient admissions, transfers and discharges
Support bed utilization and capacity management
Facilitate interdisciplinary rounds
Address barriers impacting patient progression and access to care
Maintain awareness of department capacity pressures
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