Dearborn Group

QA Engineer

• Perform oversight on essential credentialing functions to attain and maintain quality providers in the dental network
• Conduct audits for credentialing as well as network data quality
• Understand credentialing policies and procedures per NCQA, URAC and CMS standards and other regulatory requirements
• Serve as a liaison to delegated entities and vendors to ensure current and adequate credentialing processes are in place
• Develop and perform queries for data reporting purposes to include directories, ad hoc reports, and network management reports
• Monitor and maintain credentialing and re-credentialing policies and program as well as state and federal requirements to ensure compliance is met
• Provide operational and industry knowledge to ensure credentialing practices are followed

Network & Credential QA Analyst