Provider Credentialing Data Analyst

Thomas Jefferson University Hospitals is seeking a Provider Credentialing Data Analyst to support credentialing activities for JMG (Jefferson Medical Group) and JeffCare PHO physicians in alignment with National Committee for Quality Assurance (NCQA) standards. This role partners with Jefferson Medical Staff to coordinate credentialing documentation through the JeffCare Credentialing Process.

Key Responsibilities

• Complete primary source verification for each provider for initial credentialing and reappointments, following contractual requirements with delegated health plans, JeffCare delegated credentialing policies and procedures, NCQA, and the Department of Public Welfare.
• Assemble individual physician credentialing files according to established standards.
• Update and maintain demographic and credentialing information in the database.
• Maintain the integrity of the Delegation Agreement.
• Coordinate with Quality Assurance Representatives of health plans on JMG and JeffCare PHO enterprise credentialing policies and procedures for delegation.
• Prepare physician welcome letters, manage expirables, and create or run reports and queries as required.
• Manage and present materials for JeffCare Credentialing meetings, including agendas, recordings, minutes, and identifying issues, concerns, and recommendations.

Required Qualifications

• High School Diploma/GED
• 2 years of experience in credentialing/enrollment, with delegated credentialing experience strongly preferred
• Proficiency with Microsoft Office and credentialing software
• Critical thinking skills with the ability to organize and prioritize work strategically
• Detail oriented
• Ability to multi-task and meet deadlines
• Problem-solving skills, including identifying options and effective solutions to delegated credentialing questions or issues
• Ability to communicate professionally with associates, partners, and leadership
• Strong oral and written communication skills

Preferred Qualifications

• Associate’s Degree or
• Bachelor’s Degree in healthcare administration

Technologies

• Microsoft Office
• Credentialing software

Work Location and Schedule

• Location: Philadelphia, PA (onsite)
• Primary Address: 1101 Market, Philadelphia, Pennsylvania, United States of America
• Work Shift: Workday Day (United States of America)
• Worker Sub Type: Regular

Physical Demands

• Lift and carry 25 lbs.
• Frequent sitting/standing and frequent keyboard use
• Patient care providers may be required to perform activities specific to their role, including kneeling, bending, squatting, and performing CPR

Benefits

• Medical (including prescription)
• Supplemental insurance
• Dental
• Vision
• Life and AD&D insurance
• Short- and long-term disability
• Flexible spending accounts
• Retirement plans
• Tuition assistance
• Voluntary benefits (group rates on insurance and discounts)
• Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service