Credentialing Specialist II

2 weeks ago

Tallahassee, United States Centene Corporation Full time
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Qualified candidates must reside in Florida

Position Purpose:
Assist the plan in credentialing and re credentialing providers.

Credential and re-credential various providers, including physicians, healthcare delivery organizations, or pharmacies, according to applicable specifications


Input and maintain databases for timely access to accurate and current network status and to allow for meaningful analysis of network size, scope, etc.

May perform audits, including preparation and audit of credentialing documents

Act as a "go to" person for other Credentialing Specialists and provide feedback to reduce errors and improve processes

Assist with development of department policies, procedures, workflow and tools

May assist with coordinating credentialing committee

May require the ability to travel, a valid driver's license, and car insurance (depending on business unit)

Education/Experience:
High school diploma or equivalent. 4+ years of credentialing and/or provider data experience. Knowledge of NCQA or URAC and state credentialing requirements preferred.

Pay Range:
$ $38.07 per hour


Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.

Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.


Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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