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Credentialing & Network Specialist
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PrimeWest Health
Alexandria, MN (In Person)
Full-Time
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Job Description
PrimeWest Health is seeking a detail-oriented Credentialing & Network Specialist to support provider credentialing, network data management, regulatory compliance, and provider relations. This role serves as a key liaison between providers and PrimeWest Health, ensuring accurate credentialing processes, effective communication, and compliance with industry standards and regulatory requirements. Key Responsibilities Coordinate provider credentialing and recredentialing activities in accordance with NCQA standards and organizational policies. Maintain accurate provider records and credentialing data within the Provider Data Management (PDM) system. Assist providers with credentialing questions, status updates, and process education. Monitor provider compliance, disciplinary actions, and ongoing credentialing requirements. Support regulatory reporting, audits, and network submissions for DHS, CMS, and other governing agencies. Assist with provider directory and network data accuracy and compliance. Present credentialing information to committees and support credentialing review processes. Collaborate with internal departments to ensure accurate provider information and network integrity. Qualifications Associate degree in business or a related field, or equivalent combination of education and experience. Proficiency in Microsoft Word, Excel, and Outlook. Strong organizational skills, attention to detail, and ability to manage multiple priorities. Excellent verbal and written communication skills. Knowledge of healthcare credentialing processes and NCQA standards preferred. Ability to work independently and collaboratively in a professional environment. Why Join PrimeWest Health? We value our employees and offer a comprehensive benefits package, including: Medical Insurance Dental Insurance Vision Materials Coverage Long-Term Disability (LTD) Coverage Life Insurance Pension Plan (PERA) 13 Paid Holidays Vacation Bank Sick Leave Bank Paid Volunteer Hours Fitness Room Onsite At PrimeWest Health, you'll play an important role in supporting a high-quality provider network while contributing to regulatory excellence and exceptional provider service. We offer a collaborative work environment where attention to detail, professionalism, and continuous learning are valued. Apply Today!