Hybrid Department Analyst I – Credentialing

Posted last week

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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

Job title

Department Analyst I – Credentialing

Job type

Experience level

Junior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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