Contracting and Credentialing Specialist – Contractor

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🔥 2 minutes ago

🌵 Arizona, California – Remote

🌵 Arizona – Remote 🏄 California – Remote

💵 $35 / hour

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

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Amity Foundation

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1969

🤲 Charity

🤝 Non-profit

🌍 Social Impact

Charity • Non-profit • Social Impact

Amity Foundation is a non-profit organization dedicated to the inclusion and habilitation of marginalized individuals impacted by various societal issues such as addiction, trauma, poverty, and incarceration. Established in 1981 in Tucson, Arizona, it focuses on personal growth, emotional literacy, and social responsibility for its students. With campuses in California and Arizona, Amity engages in community building and aims to promote environmental, social, and economic justice through research, development, and the dissemination of information.

📋 Description

• 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.

🎯 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.