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Welcome to CommonSpirit Careers

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Credentialing Specialist

  • Dignity Health Management Services
  • Redlands, California, Remote
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About Us

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 138 hospital-based locations, in addition to its home-based services and virtual care offerings.

Our Mission

As CommonSpirit Health, we make the healing presence of God known in our world by improving the health of the people we serve, especially those who are vulnerable, while we advance social justice for all. To learn more about a calling that defines and unites, please click here for more information about our mission, vision, and values.

The posted compensation range of $28.10 - $41.80 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Job ID
2026-461943
Employment Type
Full Time
Department
Credentialing
Hours/Pay Period
80
Weekly Schedule
8:00am - 5:00pm
Shift
Day
Remote
Yes
Category
Risk and Compliance

Job Summary and Responsibilities

As the Credentialing Specialist, you will be responsible for all credentialing activities associated with all IPAs and product lines managed by Dignity Health MSO.

Every day you will manage daily credentialing operations, including resolution of non-responsive providers. You will also work collaboratively with Credentialing leadership, Medical Directors, Provider Relations Department, Contracting Department, health plans, providers, provider office staff, and other persons or businesses as necessary to ensure that all providers are properly credentialed according to NCQA and health plan standards.

To be successful in this role, you will demonstrate a comprehensive understanding of credentialing regulations and processes, possess strong organizational and communication skills, and effectively manage complex administrative tasks to ensure provider compliance and efficient operational flow.

  • Attend ICE Credentialing Shared Audit Team Workshops and Teleconferences on a monthly basis to keep informed of current and changing credentialing requirements and standards. Relay information to QM & Credentialing Supervisor for implementation and updates to Policies and Procedures.
  • Coordinate transfer of initial provider credentialing application to Credentials Verification Organization (CVO).  Monitor CVO performance of initial and recredentialing on a regular basis for evaluation and intervention, if necessary, to ensure compliance with internal credentialing time frame requirements for all IPAs
  • Collect re-credentialing applications and associated required documents from providers who are listed on the 3rd Recred Apps Sent Report posted on CVO website. Upon receipt, forward to CVO for processing.
  • Review all applications returned by CVO for accompanying documents and completeness. Request additional information from CVO or provider as needed. Reconcile monthly statement from CVO and forward to Finance Department with payment request. Notify CVO if statement is inaccurate and adjustments need to be made prior to forwarding to finance for payment.
  • Perform internal primary source verifications and full credentialing for those providers who are to be credentialed on a RUSH basis. RUSH status is to be determined by administration including CEO and Medical Directors.
  • Notify Provider Relations Department of need for site visits. Provide Site Visit Audit Tool and copies of Physician Office Policies and Procedures for Provider Relations to give to new providers at time of site visit.

***This position is work from home within California.


Job Requirements

Minimum Qualifications:


- 3-5 years of experience in the healthcare industry required, preferably with experience in credentialing.
- High School diploma or GED.
- Strong written and verbal communication skills, excellent organizational skills, and proficient in Microsoft Word, Excel, and Microsoft Outlook.
- Self-directed and able to work independently under tight time frames.
- Able to interact with co-workers, managers, supervisors, and administrators in a manner that promotes a positive work environment

Preferred Qualifications:


- 1+ years of vocational or college coursework preferred.
- Certified Provider Credentialing Specialist (CPCS) or Professional Medical Services Manager preferred.

- Experience with Catcus preferred.

- Experience with managed care credentialing strongly preferred.

Where You'll Work

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.


Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

One Community. One Mission. One California 

Total Rewards

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit our Total Rewards

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.

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CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.

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