Credentialing Specialist - Committee Specialist

Category

Business Operations

Position Type

Full-Time

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.

Under general supervision, the Credentialing Specialist – Credentials Committee ensures that the plan provider network consists of providers that meet the regulatory criteria to minimize liability to the company and to maximize safety for members.

Responsible for assisting with the coordination of enterprise-wide credentialing process for practitioners and health delivery organizations according to the Curana Health policy and procedures. Maintains a high level of confidentiality of practitioner information.

Duties to include any combination of the following:

• Maintain confidentiality regarding legal matters, privacy issues, information technology and data integrity
• Maintains credentialing software database by ensuring that data entered is complete and accurate
• Collect, analyze, and present provider-specific data for bi-monthly review by the Credentials Committee
• Track inbound and outbound communication on behalf of the Medical Directors to providers
• Communicate with health care practitioners to clarify questions and request any missing information
• Communicate with internal and external customers in a clear, concise manner to obtain or provide necessary information
• Draft and distribute formal approval letters, requests for additional information, and termination notices to practitioners in accordance with decisions made by the Credentials Committee
• Compile and summarize provider responses to requests for additional information, ensuring clarity and accuracy for review and documentation purposes
• Coordinate the preparation of the bi-monthly Credentials Committee agenda and accurately record and maintain official meeting minutes
• Review and process assigned NPDB Continuous Query reports, ensuring timely and appropriate action is taken

• High school diploma required; Associate degree preferred
• 2-5 years of hospital or insurance plan credentialing experience
• Working knowledge of Joint Commission, NCQA, URAC, HFAP standards
• Certified Provider Credentialing Specialist (CPCS) preferred

We’re thrilled to announce that Curana Health has been named the 147^th fastest growing, privately owned company in the nation on Inc. magazine’s prestigious Inc. 5000 list. Curana also ranked 16^th in the “Healthcare & Medical” industry category and 21^st in Texas.

This recognition underscores Curana Health’s impact in transforming senior housing by supporting operator stability and ensuring seniors receive the high-quality care they deserve.