Managed Care Credentialing Auditor – FPP Physicians Network

WashU IT

Credentialing Auditor ensuring compliance with NCQA standards for WashU Managed Care Credentialing. Conducting audits, maintaining records, and providing guidance to staff for quality improvement initiatives.

Posted 4/29/2026full-timeWashington • Washington • 🇺🇸 United StatesMid-LevelSenior💰 $53,100 - $90,600 per yearWebsite

About the role

Key responsibilities & impact

Conduct credentialing audits to ensure compliance with internal policies, state regulations, contractual requirements, and NCQA standards.
Acts as a liaison between WashU Managed Care Credentialing and its 40+ Managed Care Payors.
Maintains accurate and organized records of audit findings, reports, and other relevant documentation.
Evaluates credentialing processes and internal controls to identify risks and opportunities for improvement.
Communicates audit results and recommendations in a clear and professional manner.
Provides guidance and support to credentialing staff on compliance and quality improvement initiatives.

Requirements

What you’ll need

High school diploma or equivalent high school certification.
3 years of experience managing credentialing processes.
No specific certification/professional license required.
2 years of experience with Database.
Skills: Analytical Thinking, Credentialing, Critical Thinking, Delegation Management, Detail-Oriented, Effective Written Communication, Internal Auditing, Interpersonal Relationships, Microsoft Excel, Microsoft Office, Multiple Project Management, Organizing, Problem Solving, Software Program Management, Teamwork, Verbal Communications, Working Independently.

Benefits

Comp & perks

Up to 22 days of vacation, 10 recognized holidays, and sick time.
Competitive health insurance packages with priority appointments and lower copays/coinsurance.
Free Metro transit U-Pass for eligible employees.
Defined contribution (403(b)) Retirement Savings Plan with university contributions.
Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!
4 weeks of caregiver leave to bond with your new child.
Tuition coverage for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

credentialinginternal auditingdatabase managementanalytical thinkingcritical thinkingdetail-orientedsoftware program managementmultiple project managementproblem solvingorganizing

Soft Skills

effective written communicationinterpersonal relationshipsteamworkverbal communicationsdelegation managementworking independently