Job Description

Location: Steward Health Care Network
Posted Date: 1/13/2022

Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world-class doctor close to where they live.

The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.

Position Purpose: Reporting to the Credentialing Supervisor, the Credentialing Coordinator facilitates the accurate and efficient Credentialing and Recredentialing of SHCN and SMG providers in alignment with State, Federal, and NCQA standards.

  • Responsible for ensuring timely processing credentialing, recredentialing, practitioner files, organizational files and the credentialing database, and coordination of the Credentialing Committee meeting including meeting minutes.
  • Conduct internal and external validation of credentialing file audits, and address identified issues in a timely manner.
  • Facilitate prompt coordination with the Credentialing Verification Organization (CVO) and monitor files in-process, promptly addressing incoming files for processing.
  • Review and maintain all applications for accuracy and completeness, ensure primary source verification, and overall processing time frames are met.
  • Generate forms, letters, checklists, and maintain the internal tracking data base/data entry, ensuring complete and accurate data entry.
  • Contribute toward the coordination of the Credentialing Committee by accurate and complete preparation of credentialing and recredentialing files. Identify and communicate agenda items to the Credentialing Manager to be addressed at the Credentialing Committee.
  • Facilitate preparation of files for electronic storage.
  • Participate and preparation of Delegated Credentialing audits, ensuring compliance with Federal, Multi-State, Multi-Payor, and NCQA requirements.
  • Coordinate with Network Development, Provider Onboarding, or other sources as necessary on follow-up items needed to complete the credentialing process. Communicate to internal and external departments regarding status of provider and organizational credentialing.
  • Maintain on-going participation in cross-training activities. Actively engage in addressing special projects as they arise, conducting preliminary research and follow-up, and tracking/monitoring to facilitate on-going reporting of project status.
  • Provide recommendations and feedback regarding development of process improvements and/or standardization practices.
  • Other duties as assigned.

Education / Experience / Other Requirements


  • Associates degree in a related field (or equivalent combination of education and experience).
  • NAMSS CPCS Certification Preferred.

Years of Experience:

  • A minimum of three years of relevant experience in healthcare related environment, preferably within a credentialing/recredentialing environment and knowledge national accreditation or regulatory criteria.
  • Multi-State and multi-payor related Credentialing knowledge and experienced strongly preferred, required within the first year.

Specialized Knowledge:

  • Microsoft Office software (Word, Access, Excel, PowerPoint), and preferably experience with Credentialing systems.
  • Previous Managed Care and/or Medicaid experience strongly preferred.
  • Ability to analyze and evaluate data and other provider related problems in order to develop alternative solutions for a positive outcome.
  • Ability to multi-task and prioritize workload, manage multiple priorities, and pay meticulous attention to detail.
  • Thorough understanding of managed care principles and physician practice operations, with an understanding of health plan provider enrollment and credentialing preferred.
  • Excellent organizational skills, proven project management expertise; Strong verbal and written communication skills.
  • Outstanding interpersonal skills, able to quickly establish a trusting rapport with individuals at all levels.
  • Requisite poise, judgment, and trustworthiness to represent SHCN to internal and external groups.
  • Maintains information in a confidential manner according to policy.

This position is subject to the COVID-19 Vaccination Policy for Steward Health Care Workforce. Employees in this position will be required to provide adequate proof of vaccination for COVID-19 by an FDA-approved vaccine prior to starting work. Steward will consider requests for exemptions from this vaccine requirement on the basis of medical condition or sincerely held religious belief in accordance with applicable Federal laws.

Steward Health Care is an Equal Employment Opportunity (EEO) employer. Steward Health Care does 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.

Additional Information

Steward Health Care Network is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment – with confidence and without fear.

Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience:

  1. Any COVID-19 related care takes place in designated areas away from other patients and their families.
  2. A stringent cleaning policy has been implemented throughout our facilities.
  3. A strictly controlled visitor and masking policy is required for patient and colleague safety.

You can rest assured that we have made the necessary preparations to provide care in a safe, controlled and professional way.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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