Credentialing Specialist - Facility at Curana Health, Inc.

, , United States -

Full Time

Start Date

Immediate

Expiry Date

07 Jun, 26

Salary

0.0

Posted On

09 Mar, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing Review, Data Entry, Data Management, Recredentialing, Compliance Monitoring, Sanctions Review, Exclusions Review, Reporting, Documentation, Microsoft Excel, Microsoft Word, Attention To Detail, Confidentiality, Communication

Industry

Hospitals and Health Care

Description

At Curana Health, we’re on a mission to radically improve the health, happiness, and dignity of older adults—and we’re looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide range of solutions (including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans) proven to enhance health outcomes, streamline operations, and create new financial opportunities. Founded in 2021, we’ve grown quickly—now serving 200,000+ seniors in 1,500+ communities across 32 states. Our team includes more than 1,000 clinicians alongside care coordinators, analysts, operators, and professionals from all backgrounds, all working together to deliver high-quality, proactive solutions for senior living operators and those they care for. If you’re looking to make a meaningful impact on the senior healthcare landscape, you’re in the right place—and we look forward to working with you. For more information about our company, visit CuranaHealth.com. Summary The Credentialing Specialist for Facilities ensures that the health plan’s provider network includes facilities that meet regulatory standards. This position plays a crucial role in ensuring compliance, safeguarding member safety, and minimizing liability for the company. Essential Duties & Responsibilities Credentialing Review & Evaluation: Evaluate facility credentialing applications for accuracy and completeness based on specialty requirements. Obtain the necessary verifications and ensure compliance with regulatory standards. Communication: Engage with facilities to clarify credentialing-related questions and obtain missing information to complete their application. Data Entry & Management: Update and maintain credentialing software systems with necessary facility information. Perform data corrections and ensure all files are complete and up to date. Recredentialing & Follow-Up: Request and follow up on recredentialing applications, ensuring timely processing and compliance with internal guidelines. Monitoring & Compliance: Regularly monitor facilities' expiration dates for licenses, DEA certificates, and other relevant documentation. Present summary reports to the Credentialing Committee monthly. Sanctions & Exclusions Review: Review federal and state sanctions/exclusions reports to ensure facilities comply with regulations. Reporting & Documentation: Generate and distribute credentialing reports to internal teams. Prepare and send formal notices of approval, requests for additional information, and termination notices as required by the Credentialing Committee. Support & Collaboration: Assist the contracting department with credentialing support and provide ongoing status updates on facilities' credentialing status. Qualifications Education: High school diploma required; additional certification or experience in healthcare credentialing is a plus. Experience: Prior experience in credentialing or related field preferred, but not required. Skills: Proficient in Microsoft Excel and Word; familiarity with credentialing databases is a plus. Strong attention to detail and ability to maintain confidentiality. Flexible, team-oriented, and capable of working with minimal supervision. Strong verbal and written communication skills.

Responsibilities

The specialist evaluates facility credentialing applications for accuracy and completeness against regulatory standards, communicates with facilities to clarify questions, and maintains necessary data in credentialing software systems. This role also involves monitoring expiration dates, reviewing sanctions reports, and generating required compliance documentation.