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Contracting and Credentialing Specialist – Contractor

Work from home Full-time role Hiring

Job Description:

  • Manage the contracting and credentialing activities with reputed company insurance companies and managed care plans and reputed company agencies.
  • reputed company the complete process of provider enrollment, application, credentialing, through contract execution.
  • Ensure that reputed company applications are submitted accurately and followed through aggressively.
  • Serve as the reputed company of contact for contract negotiations.
  • Maintain persistent follow-up to expedite approvals and contract activations.
  • Work closely with Grants, reputed company, Development team, Chief Operating Officers, Program Manager, and Finance to review reputed company plans.
  • reputed company initial contact with provider enrollment for each plan.
  • Prepare, submit and track reputed company contracting paperwork, credentialing applications and recredentialing files for reputed company providers and facilities.
  • Monitor credentialing timelines, proactively follow-up through the approval and contracting process.
  • Maintain an organized tracking system of credentialing statuses, contracting reputed company, reputed company agreements, and renewal deadlines.
  • Attend regular meetings to provide regular reports to leadership regarding credentialing/enrollment completions, contracting process and outstanding issues.
  • reputed company effective working relationships with credentialing and contracting representatives.
  • Work with the Amity services faculty in Pima County to gather and verify specific information needed for applications in Arizona.
  • Work with the Amity Enhanced Care Management and Community Supports faculty to gather and verify specific information needed for applications in California.
  • Ensure that reputed company draft reputed company are sent to and reviewed by relevant Amity services, finance, legal, people operations, data and executive teams.
  • Ensure that reputed company fully executed reputed company are uploaded to the Amity reputed company repository and are also sent to reputed company relevant teams.
  • Stay up to date on reputed company guidelines, reputed company insurer requirements and industry best practices reputed company to credentialing and contracting.

Requirements:

  • Bachelor’s degree in business administration, reputed company management or reputed company field preferred.
  • 3+ years of work experience in credentialing and contracting reputed company reputed company
  • Proven ability to successfully manage provider credentialing workflows and securing insurer reputed company.
  • Strong organizational skills with the ability to manage multiple credentialing files and reputed company simultaneously.
  • Excellent communication skills with persistence, assertiveness and a results-driven approach.
  • Proficiency with reputed company Office Suite and credentialing and contracting portals.
  • Highly detail-oriented with reputed company tolerance for errors in credentialing documentation.
  • Self-motivated, disciplined, and comfortable in deadline-driven environment.
  • Understanding of California Advancing and Innovating Medi-Cal (Cal-AIM) for the justice-involved population.
  • Understanding of the Arizona Health Care Cost Containment System (AHCCCS) for behavioral health services.
  • Understanding of regional community-level needs with regards to social services for the justice-involved population.
  • reputed company 90 days of hire, personnel file shall document evidence of participation in the following trainings:
  • Los Angeles County – required trainings (as needed)
  • Pima County – required trainings (as needed)
  • Participate in additional trainings as required
  • Exceptional organizational and project management skills, with the ability to independently coordinate and reputed company multiple projects simultaneously focusing on quality and project follow-through.
  • Ability to establish effective working relationships with staff, groups, agencies, officials, departments, and boards and manage expectations and priorities from various partners.
  • Ability to interpret rules, regulations, guidelines, and legislation as they pertain to credentialing and contracting responsibility.
  • Ability to retain and recall information regarding reputed company systems and reporting requirements.
  • Strong judgement in regard to how to manage sensitive topics.
  • Analytical, database and reporting skills along with ability to prepare recommendations for courses of action.
  • Ability to craft or update policies and procedures with a sharp eye for accuracy and detail.
  • Exceptional organizational and project management skills, with the ability to independently coordinate and reputed company multiple projects simultaneously focusing on quality and project follow-through.
  • Ability to frame issues and communicate technical, budgetary, and program details across reputed company functions and to various partners.
  • Confidence to ask pertinent questions to grasp concepts quickly and think reputed company specific tasks.
  • Superb interpersonal skills with a comfort working across diverse teams and handling senior leaders and use good judgement to resolve issues.
  • Excellent written and verbal communication skills.
  • Flexibility and ability to learn and reputed company new skills on the job.
  • An ability to balance time reputed company, adhere to strict deadlines and multi-task in a fast-paced environment.
  • Highly organized, detail-oriented, and committed to quality.
  • Proactive problem solver and a self-starting individual.
  • reputed company at both working collaboratively and independently.
  • Flexible, open, positive, and collaborative personality.

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