Credentialing Specialist

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Boston, MA, USA
In-Office
29-52 Hourly
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Requisition Number: 2352978
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together.
Hours: Monday-Friday 8:00am to 4:00pm ET
You'll enjoy the flexibility to work remotely * North of Boston, MA.
Primary Responsibilities:
  • Help process provider applications and re-applications including initial mailing, review and loading into the database tracking system
  • Conduct audits and provide feedback to reduce errors and improve processes and performance
  • Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others
  • Help develop credentialing policies and procedures and, occasionally, oversee primary source verification activities
  • Investigate non-standard requests and problems

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • High School Diploma/GED
  • 1+ years of experience with credentialing/re-credentialing and/or privileging in the health care industry
  • 1+ years of experience with health care accreditation and regulatory standards
  • Intermediate level of proficiency with MS Excel & Word
  • Access to reliable transportation and valid US driver's license

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable .
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #GREEN

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Healthcare Strength Health coverage offers multiple plan types with employer HSA contributions, in‑network preventive care at 100%, and included 24/7 virtual visits, alongside dental and vision options. This breadth allows predictable copay choices or tax‑advantaged HSA designs to fit different usage needs.
  • Retirement Support Retirement programs include a 401(k) with employer match eligibility and full vesting over time plus an Employee Stock Purchase Plan at a discount. Together these elements support long‑term savings and ownership.
  • Parental & Family Support Family supports include six weeks paid parental leave, paid caregiver leave, adoption assistance, and subsidized Bright Horizons back‑up care. Emotional well‑being resources like a premium Calm subscription and a 24/7 EAP complement these supports.

Optum Insights

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

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