Credential Analyst – NCQA, URAC, CMS

Dearborn Group

Credential Analyst managing credentialing functions for quality dental providers at Dearborn. Partnering with vendors and ensuring compliance with NCQA, URAC, and CMS standards.

Posted 4/29/2026full-timeLombard • Illinois, Missouri, Texas • 🇺🇸 United StatesJuniorMid-Level💰 $38,100 - $80,000 per yearWebsite

About the role

Key responsibilities & impact

Responsible for performing oversight on essential credentialing functions to attain and maintain quality providers in the dental network.
Conducts audits for credentialing as well as network data quality.
Understands credentialing policies and procedures per NCQA, URAC and CMS standards and other regulatory requirements.
Serves as a liaison to delegated entities and vendors to ensure current and adequate credentialing process are in place.
Develops and performs queries for data reporting purposes to include directories, ad hoc reports, and network management reports.
Responsible for the monitoring and maintenance of credentialing and re-credentialing polies and program as well as state and federal requirements to ensure compliance is met.
Provides operational and industry knowledge to ensure credentialing practices.

Requirements

What you’ll need

Bachelor degree and 2 years of experience in accreditation programs (i.e., NCQA, URAC and CMS programs) or 6 years of experience in accreditation programs
Proficiency in accreditation program standards. (ex. NCQA, URAC, CMS)
Knowledge of state and federal requirements for contracting and credentialing.
Attention to detail and ability to track information to defined quality standards
Knowledge of documents and their contents used in provider contracting, including applications, agreements, fee schedules, and credentialing.
Knowledge of provider contracting terms.
Analytical skills
Demonstrated experience understanding and maintaining detailed complex provider records.
Attention to detail and ability to enter data and meet defined quality standards
Experience balancing multiple priorities while meeting commitments for quality and delivery at agreed upon schedules.
Clear and concise verbal and written communication skills.
Proficient in Microsoft Office products, Excel, email and Internet.
Ability to work well in a team environment.

Benefits

Comp & perks

Health and wellness benefits
401(k) savings plan
Pension plan
Paid time off
Paid parental leave
Disability insurance
Supplemental life insurance
Employee assistance program
Paid holidays
Tuition reimbursement
Other incentives

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

accreditation programscredentialing policiesdata reportingdata quality auditsprovider contractinganalytical skillsattention to detailquality standardscomplex provider recordscredentialing standards

Soft Skills

clear communicationwritten communicationteamworkability to balance prioritiesoperational knowledge

Certifications

Bachelor degree