Credentialing Risk & Compliance Specialist Hybrid, Dallas, TX

ESSENTIAL DUTIES AND RESPONSIBILITIES
The responsibilities listed here represent the majority of the role but are not all-inclusive; other duties may be assigned.

• Analyze daily reporting to identify credentialing risks related to licenses certifications privileges and expirables
• Review provider schedules 30 days in advance to proactively identify potential disruptions
• Assess level of risk and prioritize issues based on impact to scheduled shifts compliance and client relationships
• Determine appropriate course of action to mitigate risk exercising independent judgment
• Lead resolution of credentialing gaps prior to shift impact ensuring timely and accurate outcomes
• Coordinate across credentialing scheduling and operations to remove barriers
• Independently drive issues to resolution escalating only when necessary with clear recommendations
• Maintain accountability for ensuring no preventable disruptions occur
• Serve as a central point of coordination across teams impacting provider readiness
• Clarify ownership align stakeholders and ensure follow-through on action items
• Communicate risk status and resolution plans clearly and proactively to stakeholders
• Ensure accuracy and completeness of credentialing data used for decision-making
• Identify trends systemic gaps or recurring issues and recommend improvements
• Contribute to development of more proactive reporting workflows and risk mitigation strategies

QUALIFICATIONS

Knowledge Skills Abilities:To perform this job successfully an individual must be able to perform each essential duty satisfactorily

• Ability to assess prioritize and mitigate credentialing-related risk by analyzing expirables provider schedules and downstream operational impact
• Ability to exercise independent judgment and decision-making in determining appropriate actions escalation paths and resolution strategies
• Strong analytical skills including the ability to interpret reporting/data and translate findings into actionable next steps
• Ability to take ownership of issues end-to-end driving resolution across multiple stakeholders and ensuring no gaps remain
• Advanced organizational and prioritization skills in a fast-paced high-risk environment with competing deadlines
• Ability to influence and coordinate across cross-functional teams without direct authority
• Working knowledge of provider credentialing processes including licensure certifications privileging and expirables
• Strong communication skills with the ability to clearly articulate risk status and expectations to stakeholders
• Ability to identify system-level issues vs. individual performance concerns and recommend appropriate solutions
• Proficiency in navigating systems and reporting tools (e.g. credentialing platforms Excel) to support analysis and tracking

Education / Experience: Include minimum education technical training and/or experience preferred to perform the job.

:

• HS Diploma or GED equivalent
• 2 years of experience in provider credentialing healthcare operations or related field
• Experience working with credentialing data reporting or systems
• Demonstrated ability to manage high-risk time-sensitive work

Preferred:

• Bachelors Degree in Healthcare Management Business or a related field
• Experience in hospital MSO or physician services environment
• Experience working cross-functionally in a shared services environment

PHYSICAL DEMANDS:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

• Specific vision requirements include the ability to see at close range distance vision peripheral vision depth perception and the ability to adjust focus
• While performing the duties of this job the employee is regularly required to talk and hear
• Frequently required to stand walk sit use hands to feel and reach with hands and arms.
• Possess the ability to fulfill any office activities normally expected in an office setting to include but not limited to remaining seated for periods of time to perform computer-based work participating in filing activity lifting and carrying office supplies (paper reams mail etc.)
• Occasionally lift and/or move up to 20-25 pounds
• Fine hand manipulation (keyboarding)

WORK ENVIRONMENT:The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• This is a hybrid role with a strong emphasis on onsite presence and communication.
• Typical in-office days are Tuesday-Thursday and can vary base don business needs
• Regular attendance at the office is essential to support work initiatives and respond to in-person requests.
• Standard business hours apply with flexibility as needed to accommodate early mornings evenings or occasional weekend projects and meetings.
• Location: 4835 LBJ Fwy Dallas TX 75244 - Suite #900

The company is committed to creating a diverse inclusive and equitable environment and is proud to be an equal opportunity employer. Qualified applicants of any age race religion nationality sexual orientation gender identity or expression disability or veteran status will receive equal consideration for positions. We welcome people of diverse backgrounds experiences and abilities and believe that the unique experiences of our team drive our success.