Amity, internationally recognized for its success, serves individuals & families affected by homelessness & addiction.
Contracting and Credentialing Specialist – Contractor
Location
Arizona + 1 moreAll locations: Arizona | California
Posted
16 hours ago
Salary
$35 / hour
Seniority
Senior
Job Description
Contracting and Credentialing Specialist – Contractor
Amity Foundation
• Manage the contracting and credentialing activities with commercial insurance companies and managed care plans and Medicaid agencies. • Oversee the complete process of provider enrollment, application, credentialing, through contract execution. • Ensure that all applications are submitted accurately and followed through aggressively. • Serve as the point of contact for contract negotiations. • Maintain persistent follow-up to expedite approvals and contract activations. • Work closely with Grants, Contracts, Development team, Chief Operating Officers, Program Manager, and Finance to review current plans. • Make initial contact with provider enrollment for each plan. • Prepare, submit and track all contracting paperwork, credentialing applications and recredentialing files for all providers and facilities. • Monitor credentialing timelines, proactively follow-up through the approval and contracting process. • Maintain an organized tracking system of credentialing statuses, contracting progress, rate agreements, and renewal deadlines. • Attend regular meetings to provide regular reports to leadership regarding credentialing/enrollment completions, contracting process and outstanding issues. • Develop 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 all draft contracts are sent to and reviewed by relevant Amity services, finance, legal, people operations, data and executive teams. • Ensure that all fully executed contracts are uploaded to the Amity contracts repository and are also sent to all relevant teams. • Stay up to date on Medicaid guidelines, commercial insurer requirements and industry best practices related to credentialing and contracting.
Job Requirements
- Bachelor’s degree in business administration, healthcare management or related field preferred.
- 3+ years of work experience in credentialing and contracting within healthcare
- Proven ability to successfully manage provider credentialing workflows and securing insurer contracts.
- Strong organizational skills with the ability to manage multiple credentialing files and contracts simultaneously.
- Excellent communication skills with persistence, assertiveness and a results-driven approach.
- Proficiency with Microsoft Office Suite and credentialing and contracting portals.
- Highly detail-oriented with zero 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.
- Within 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 lead 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 lead multiple projects simultaneously focusing on quality and project follow-through.
- Ability to frame issues and communicate technical, budgetary, and program details across all 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 develop new skills on the job.
- An ability to balance time efficiently, 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.
- Excel at both working collaboratively and independently.
- Flexible, open, positive, and collaborative personality.
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