At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

                        

We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.

                                    

Job TitleDepartment Analyst I - Credentialing

                        

LocationCleveland

                    

FacilityRemote Location

                     

DepartmentMarket and Network Services MNS-Finance

                      

Job CodeT22012

                     

ShiftDays

                       

Schedule8:00am-5:00pm/7:00am-4:00pm

                       

Job Summary

                         

Job Details

Join the Cleveland Clinic team where you will work alongside passionate caregivers and make a lasting, meaningful impact on patient care. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world.      

At Cleveland Clinic, everyone is considered a caregiver, whether serving in a healthcare, customer service, administrative, or analytic role. As a Department Analyst, your caregiving begins in the office, where you will analyze and evaluate operational resources, data collection processes, services, programs, systems, budgets, and departmental procedures. In this role, you will also manage credentialing for Cleveland Clinic Foundation (CCF) providers, the largest provider group within the credentialing team, consisting of approximately 6,500 providers, ensuring they meet all health plan credentialing requirements and are accurately represented on delegated credentialing rosters. This position involves high-volume work with strict deadlines and rapid turnaround times following credentialing committee approvals.

A caregiver in this role works remotely from 8:00 a.m. -- 5:00 p.m. or 7:00 a.m. – 4:00 p.m.

To be considered for this position, you must reside locally and may be required to report to the West Creek facility on an occasional basis for meetings.

A caregiver who excels in this role will:  

Analyze and evaluate operational and financial functions of administrative and operational units. 

Analyze departmental resources, services, systems, budgets and programs. 

Prepare and develop special reports and recommendations based on analysis.

Conduct basic statistical analysis and evaluation of unit services and performance. 

Identify program or service strengths, weaknesses, and financial impact. 

Identify opportunities for service and program improvement. 

Assist with the development of operational plans, procedures and systems. 

Review and evaluate current procedures and systems and develop recommendations for improvement. 

Maintain awareness of and comply with various regulatory guidelines (JCAHO, FDA, HIPAA, OSHA, etc.). 

Manage credentialing for CCF providers across multiple commercial health plans.

Ensure compliance with health plan credentialing criteria and delegated credentialing standards.

Perform primary source verification for licensure and credentials.

Maintain and update large provider rosters in Excel.

Meet tight deadlines (36–48 hours post-committee approval) for releasing providers to health plans.

Coordinate with internal teams to ensure accurate and timely credentialing

Minimum qualifications for the ideal future caregiver include:  

Bachelor’s Degree in Business, Healthcare Administration or a related field and one year of statistical analysis experience or five years of relevant experience in a health care setting

OR High School Diploma/GED and five years of experience

OR Associate's Degree and three years of experience

OR Master's Degree 

Two years of commercial health plan credentialing experience

OR medical staff office credentialing experience

Preferred qualifications for the ideal future caregiver include:

Excel proficiency: (filtering, sorting, find/replace, navigating large rosters)

Understanding of credentialing criteria for health plans

Knowledge of delegated credentialing vs. manual enrollment

Knowledge of primary source verification processes

Comfortable working in a fast-paced environment with large data sets

Experience with credentialing processes and compliance standards

Physical Requirements:

Ability to perform work in a stationary position for extended periods

Ability to operate a computer and other office equipment

Ability to communicate and exchange accurate information

Personal Protective Equipment:

Follows standard precautions using personal protective equipment as required. 

                       

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances.

Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility. 

Please review the Equal Employment Opportunity poster. 

                  

Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities