Contracting and Credentialing Specialist – Contractor

Job Description:

• Manage the contracting and credentialing activities with commercial insurance companies and managed care plans and Medicaid 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 Medicaid guidelines, commercial insurer requirements and industry best practices reputed company to credentialing and contracting.

Requirements:

• Bachelor’s degree in business administration, healthcare management or reputed company field preferred.
• 3+ years of work experience in credentialing and contracting reputed company healthcare
• 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 accounting 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 beyond 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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