Hybrid Department Analyst I – Credentialing

at Cleveland Clinic

• Job title: Department Analyst I – Credentialing
• Job type: Full Time
• Experience level: Junior
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Cleveland, United States

About the role

• Department Analyst focusing on operational resources, data analysis, and managing health plan credentialing for Cleveland Clinic. This role ensures providers meet credentialing requirements with strict deadlines.

Responsibilities

• Analyze and evaluate operational and financial functions of administrative and operational units
• Analyze departmental resources, services, systems, budgets and programs
• Prepare and develop special reports and recommendations based on analysis
• Conduct basic statistical analysis and evaluation of unit services and performance
• Identify program or service strengths, weaknesses, and financial impact
• Identify opportunities for service and program improvement
• Assist with the development of operational plans, procedures and systems
• Review and evaluate current procedures and systems and develop recommendations for improvement
• Maintain awareness of and comply with various regulatory guidelines (JCAHO, FDA, HIPAA, OSHA, etc.)
• Manage credentialing for CCF providers across multiple commercial health plans
• Ensure compliance with health plan credentialing criteria and delegated credentialing standards
• Perform primary source verification for licensure and credentials
• Maintain and update large provider rosters in Excel
• Meet tight deadlines (36–48 hours post-committee approval) for releasing providers to health plans
• Coordinate with internal teams to ensure accurate and timely credentialing

Requirements

• Bachelor’s Degree in Business, Healthcare Administration or a related field and one year of statistical analysis experience or five years of relevant experience in a health care setting
• High School Diploma/GED and five years of experience OR Associate's Degree and three years of experience OR Master's Degree
• Two years of commercial health plan credentialing experience OR medical staff office credentialing experience
• Excel proficiency: (filtering, sorting, find/replace, navigating large rosters)
• Understanding of credentialing criteria for health plans
• Knowledge of delegated credentialing vs. manual enrollment
• Knowledge of primary source verification processes
• Comfortable working in a fast-paced environment with large data sets
• Experience with credentialing processes and compliance standards

Benefits

• Outstanding, comprehensive offerings
• Investment in your health, well-being and future