Credentialing Specialist II

The Credentialing Specialist II is responsible for managing their workload, addressing all functions for initial and re-credentialing of Health Delivery Organizations (HDOs) and initial and re-credentialing of applicants in accordance with departmental policies and procedures, National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services(CMS), California Department of Health Care Services (DHCS) requirements. This incumbent ensures data accuracy of incoming applications and re-credentialing review forms, monitoring data into Visual Cactus. Committee preparation which includes reporting, analysis, and meeting monthly deadlines. All expiries must be maintained and current. Any providers or practitioners identified as having any expired documents must be recommended for removal from the network per policies and procedures. Provider and practitioner data must be accurate and current in our Cactus database.