Job Description

Location: Steward Health Care
Posted Date: 5/22/2023

About Steward Health Care
Nearly a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.
As the country’s largest physician-led, tax paying, integrated health care system, our doctors can be certain that we share their interests and those of their patients. Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.
Steward is among the nation’s largest and most successful accountable care organizations (ACO), with more than 5,500 providers and 43,000 health care professionals who care for 12.3 million patients a year through a closely integrated network of hospitals, multispecialty medical groups, urgent care centers, skilled nursing facilities and behavioral health centers.
Based in Dallas, Steward currently operates 39 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah.
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Under the direction of the Senior Director of Credentialing Verification Office with daily activities supervised by the Credentialing Manager, this position performs all duties for initial and recredentialing file processing per NCQA, The Joint Commission, state and federal regulations and Medical Staff By-Laws.


Responsibilities include, but are not limited to:

  • Coordinates the credentialing and recredentialing process for assigned providers.
  • Collects and maintains all pertinent information from the provider. Communicates consistently with providers and provider office staff in a timely and effective manner to follow up to obtain required documents on a timely basis in alignment with processing guidelines.
  • Verifies all credentialing elements, including but not limited to, education, training, board certification, work history, licensure and certifications, malpractice coverage
  • Through a variety of primary sources as appropriate per NCQA and The Joint Commission standards.
  • Enters data accurately and completely in the credentialing software.
  • Analyzes provider files for completeness, accuracy, consistency, gaps in work history, relevant references, etc. Identifies issues and initiates further data collection as needed. Communicates handoff to appropriate Medical Staff Office.
  • Maintains thorough understanding of NCQA, The Joint Commission, and Commonwealth of Massachusetts credentialing standards.
  • Manages expirables as assigned.
  • Organizes and maintains paper and electronic files as required.
  • Meets assigned file processing quality and quantity standards.
  • Generates routine reports to assure timeliness of verifications, appropriate recredentialing dates, and processing of expirables.
  • Performs routine file audits.
  • Other duties as assigned.


· Strong organizational, problem solving, and prioritization skills as demonstrated by the successful and timely completion of assignments.

· Excellent verbal and written communication skills, ability to interact with all levels of personnel

· Keen attention to detail

· Experience working in a team-oriented, collaborative and matrix environment

· Working knowledge of Microsoft Office, Skype and other software used in daily work


· Education: Bachelor's degree or equivalent education and experience

· Experience:

Three or more years of credentialing experience in a medical staff services department or managed care plan desired.

Experience with Initial and Reappointment file processing according to NCQA and TJC standards.

National Certified Provider Credentialing Specialist Certification preferred.

Steward Health Care is proud to be a minority, physician owned organization. Diversity, equity, inclusion and belonging are at the foundation of the care we provide, the community services we support and all our employment practices. We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.

Application Instructions

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