Site Inspector - Credentialing

SH-1059 Site Inspector - Credentialing - Indiana

Summary:

Position Summary:

We are seeking a detail-oriented and highly organized Site Inspector - Credentialing - to join our team. The successful candidate will conduct on-site inspections of healthcare facilities to ensure compliance with credentialing standards, regulatory requirements, and quality benchmarks. This role is integral to maintaining a high-quality provider network and ensuring the safety and satisfaction of patients served by the network.

Key Responsibilities

• Site Inspections and Evaluations:

• Perform on-site inspections of provider facilities, including clinical and administrative areas, to assess compliance with company standards, state and federal regulations, and accreditation requirements (e.g., NCQA).

• Evaluate physical environments for cleanliness, accessibility, equipment maintenance, and patient safety protocols.

• Review facility policies, procedures, and documentation related to patient care, infection control, and emergency preparedness.

• Credentialing Verification:

• Confirm licensure, certifications, and accreditations of healthcare providers and facilities during site visits.

• Ensure adherence to operational and staffing standards, including adequate training and credentialing of clinical staff.

• Reporting and Documentation:

• Document findings in detailed inspection reports, highlighting areas of compliance and deficiencies.

• Recommend corrective actions and follow up on implementation to ensure compliance.

• Stakeholder Engagement:

• Act as a liaison between the provider network and the credentialing department to address compliance issues.

• Educate providers on credentialing standards and assist in improving their readiness for inspections.

• Conduct interviews with healthcare staff, management, and providers to gather insights on operations and patient care practices.

• Analyze staff qualifications and training programs to ensure adherence to best practices in healthcare delivery.

• Quality Assurance and Continuous Improvement:

• Collaborate with internal teams to improve credentialing processes and provider onboarding.

• Participate in quality assurance initiatives to enhance overall provider network performance.

• Travel:

• Travel to provider locations as required for on-site inspections.

Qualifications

Education and Experience:

• Associate's degree in Healthcare Administration, Social Work, Nursing, Public Health, or a related field, Certified Medical Assistant or Registered Medical Assistant with relevant experience.

• 2-3 years of experience in clinical setting or healthcare operations.

Skills and Certifications:

• Understanding of state Medicaid guidelines, regulations, and policies

• Strong knowledge of healthcare accreditation standards (e.g., NCQA, Join Commission

• Familiarity with regulatory requirements, including HIPAA and OSHA

• Familiarity with coding practices (ICD 10, CPT coding) is preferred.

• Certification in healthcare credentialing or quality (e.g., CPCS, CPHQ, CJCP) is preferred.

• Excellent communication and interpersonal skills for provider engagement.

• Proficient in Microsoft Office Suite and credentialing software systems.

Other Requirements:

• Valid driver's license and reliable transportation for travel to provider sites.

• Ability to manage multiple inspections and meet deadlines in a fast-paced environment.

Syra Health is an equal opportunity employer and values diversity at all levels. Lived experience and non-traditional backgrounds are welcomed and encouraged.