Operations Analyst (Credentialing and Provider Operations)
Job Title:
Operations Analyst (Credentialing and Provider Operations)
Type:
Full Time
Location:
Remote
About Us:
KeyCare offers health systems access to a network of virtual care providers working on KeyCare's Epic-based EMR and telehealth platform. This allows KeyCare to improve access for patients across the United States, while keeping their care coordinated with their health system partners. Health systems can start with nationwide virtual on-demand urgent care coverage (24x7, 50-state coverage), and then may add other virtual health services based on their needs. To learn more about KeyCare, visit www.keycare.org
Position Overview:
The Operational Analyst for Credentialing and Provider Operations will be responsible for managing the credentialing process for our telehealth providers, ensuring compliance with healthcare regulations, and supporting both patient and provider operations. This role will involve close collaboration with the operations and growth teams to analyze client volumes using predictive demand software, aligning recruitment and credentialing efforts with projected needs. The ideal candidate has a background in healthcare, particularly with credentialing and billing processes, including both client and direct insurance billing.
Key Responsibilities:
Provider Credentialing Management
• Oversee the credentialing and re-credentialing processes for telehealth providers, ensuring all providers meet regulatory and insurance compliance requirements.
• Manage and maintain accurate credentialing records and ensure timely renewals.
• Collaborate with providers to facilitate insurance billing setup, including both client insurance and direct billing requirements.
Operational Collaboration and Demand Assessment
• Work with the operations and growth teams to review and analyze patient and client volume trends within the predictive demand software.
• Align credentialing and provider operations with projected client demands to ensure adequate provider coverage.
• Provide insights from demand forecasting to guide recruitment and onboarding timelines.
Provider and Patient Support
• Offer general support for telehealth providers, addressing credentialing questions, billing setup, and other operational needs.
• Assist in resolving patient inquiries related to provider availability and credentialing status.
• Ensure a smooth onboarding process for new providers by coordinating with cross-functional teams on credentialing and billing setup.
Data Tracking and Reporting
• Track credentialing timelines, insurance verification statuses, and onboarding progress, regularly updating relevant stakeholders.
• Generate reports on provider credentialing metrics, including completion rates, bottlenecks, and compliance updates.
• Provide regular feedback on process improvements to optimize the credentialing workflow.
Qualifications:
• 3+ years of experience in healthcare operations, credentialing, or a related field, preferably within a telehealth or digital health environment.
• Strong understanding of credentialing requirements, healthcare regulations, and insurance billing, including experience with client insurance billing and direct insurance billing processes.
• Proficiency in predictive analytics tools and familiarity with demand forecasting within a healthcare context.
• Excellent organizational skills, with attention to detail in managing provider records and compliance documentation.
• Strong communication skills for cross-functional collaboration and provider/patient support.
Education, Experience, and Licensing Requirements
• Bachelor’s degree in Healthcare Administration, Business Administration, or a related field.
• Additional certifications in credentialing, healthcare operations, or medical billing are highly desirable.
Travel Requirements
• TBD, hybrid position in Chicago Office.
Benefits:
Eligible for company benefits upon package roll out:
• Medical
• Vision
• Dental
• Life Insurance
• Disability
• Unlimited PTO
How to Apply:
Please reach out to the email listed below.
Include the position title you are applying to in the subject line.
Include a brief intro in the body, and attach your cover letter and resume to the email. Our team will reach out with next steps.
How to Apply:
Please reach out via the external link button below.
You will be asked to attach a resume, and provide required personal info & provider details.
KeyCare is an Equal Opportunity/Affirmative Action Employer
We encourage all qualified applicants to apply. KeyCare is committed to its evolution towards a diverse and inclusive workplace. All qualified applicants will receive consideration for employment without regard to race, ethnicity, religion, gender or gender identity, sexual orientation, age, marital status, disability, sex, country of origin, or veteran status.
Reach Out to Our Team Today!
Our team is looking forward to hearing from you, and happy to answer any questions
