Save Job Back to Search Job Description Summary Similar JobsBe part of a growing shared services company in a non profit health care companyOpportunity to gain pioneering experience in a hybrid work setupAbout Our ClientOur client is a leading organization in the U.S. health and safety sector, recognized for its focus on innovation, high-quality patient care, and operational excellence. Its expanding global capability center in Taguig, Philippines offers a stable and mission-driven work environment, multinational collaboration, and strong prospects for long-term career advancement.Job DescriptionKey Responsibilities of the Credentialing Compliance Analyst:Review and maintain managed care contracts to ensure compliance with organizational standards, regulatory requirements, and approved contract language.Serve as a subject matter resource for contract terms, payer policies, reimbursement methodologies, and managed care regulations.Maintain accurate contract repositories, fee schedules, and payer policy inventories to support operational consistency and reporting needs.Analyze contract language, policy updates, and payer communications to assess business and financial impact.Research, document, and resolve payer-related issues, disputes, claims inquiries, and reimbursement concerns.Coordinate with internal stakeholders to support contract implementation, compliance monitoring, and operational readiness.Prepare reports, summaries, and executive-level analyses regarding managed care agreements and payer performance.Identify and implement process improvement opportunities that enhance contract management efficiency, accuracy, and standardization.The Successful ApplicantSuccessful Candidate Profile - Credentialing Compliance AnalystBachelor's degree in Business Administration, Healthcare Administration, Finance, Information Systems, or a related field.Proven experience within the US healthcare industry, preferably supporting managed care, provider operations, payer relations, healthcare administration, or revenue cycle functions.Experience in provider credentialing and enrollment processes, including coordination with health plans, verification of provider information, and maintenance of provider records.Working knowledge of managed care contracts, reimbursement methodologies, payer policies, healthcare regulations, and claims processes.Familiarity with credentialing, provider data management, contract management, and healthcare information systems.Strong analytical and problem-solving skills with the ability to interpret complex healthcare contracts and payer requirements.Advanced proficiency in Microsoft Office applications, particularly Excel, Word, PowerPoint, and Outlook.Excellent stakeholder management and communication skills with the ability to collaborate across multiple departments and external healthcare partners.What's on OfferJoin a respected organization in the health and safety industry where your work helps ensure quality care and regulatory compliance. This role offers a hybrid work setup, a night shift schedule, and a competitive compensation package. You'll be part of a team focused on maintaining high standards in provider credentialing and operational excellence.ContactJuan Dela CruzQuote job refJN-102026-7119301Phone number+63277955008Job summaryFunctionLife SciencesSub SectorHospitals & ClinicsWhat is your area of specialisation?Healthcare / PharmaceuticalLocationTaguigJob TypePermanentConsultant nameJuan Dela CruzConsultant contact+63277955008Job ReferenceJN-102026-7119301Work from HomeWork from Home or Hybrid
