Position Summary:
The Network Activation Credentialing Specialist supports network operations, compliance monitoring, and provider data integrity. The role ensures network providers comply with company, state, and regulatory body requirements, including NCQA, URAC, Medicare, Medicaid, and delegation agreements, by reviewing, validating, and analyzing provider information. The Credentialing Specialist also drives process improvements, handles stakeholder inquiries, and provides administrative and operational support to meet departmental needs.

Roles & Responsibilities:
Support diverse network activation projects and operations to ensure department-wide compliance and efficiency.
Manage clinician enrollment, state licensure applications, and renewals according to state and federal guidelines.
Ensure strict adherence to business, state, and accrediting body regulatory requirements, including NCQA, URAC, Medicare, Medicaid, and delegation agreements.
Maintains data tracking and facilitates provider data integrity across organizational units.
Prepare education and training materials on Network Activation policies, procedures, and quality standards, and conduct training to enforce standards.
Drive process improvement initiatives, manage stakeholder inquiries, and execute administrative and operational support to accommodate flexible departmental needs.

Required Qualifications:
3-5 years of successful work experience in a Network Activation or credentialing/Licensing role

Preferred Qualifications:
NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) within 2 years of eligibility to certify.
Intermediate skills in Google Suite Applications such as Gmail, Google Calendar, Google Sheets and Slide Presentations

Education:
High School Diploma

Experience & Skills:
Preferred Experience: 1–3 years
Credentialing or licensure experience highly preferred

Top 3 Non-Negotiables:
Ability to verify licensure and education
Experience filling out applications
Strong attention to detail and admin skills

Notes:
Work Schedule:
Flexible shifts between 7:00 AM – 5:00 PM CST
Options for 30-minute or 1-hour lunch breaks
Must work CST hours regardless of time zone