Healthcare Credentialing & Provider Relations Specialist

Key Role Summary

The Healthcare Credentialing & Provider Relations Specialist ensures provider credentialing, privileging, and payer enrollment are accurate, current, and compliant for patient care at Reno-Sparks Tribal Health Center. This role protects the integrity of provider records, supports timely access to care, and aligns with regulatory, accreditation, and payer standards.

Responsibilities

• Process initial and ongoing credentialing/re-credentialing files
• Verify licensure, education, training, certifications, malpractice history, and references
• Maintain provider data and track expirations
• Coverage of commercial payer contracts and enrollments with NextGen RCM Credentialing
• Review provider contracts and job descriptions for completeness and compliance
• Maintain revision/approval documentation
• Serve as a liaison to support TMFQHC written care coordination agreements (WCCA)

Qualifications

• High School Diploma/GED (required)
• Associate's degree (preferred)
• 3+ years relevant credentialing experience (required)
• Familiarity with CAQH/Health Stream
• Strong organization, communication, and analytical skills

Total Rewards

• Medical: Hometown Health PPO (RSIC contribution varies by tier)
• Dental: Lincoln Dental (RSIC contribution varies by tier)
• Vision: Lincoln Vision (RSIC contribution varies by tier)
• Paid Time Off: 4 hours per pay period (usable after probation; increases after 5 years per policy)
• Sick Leave: 4 hours per pay period (available immediately)
• Paid Holidays: 13 paid holidays per year
• 401(k): Eligible for employee contributions after 60 days; discretionary RSIC contribution; employer matching begins after 1 year of full-time employment

Application Information

Hiring preference is provided to qualified members of the Reno-Sparks Indian Colony followed by members of other federally recognized tribes. The Reno-Sparks Indian Colony requires any designated candidate to complete a pre-employment criminal background check, drug screen, and confirmation of professional references.