Managed Care Credentialing Specialist

🔥 8 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 14%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Pennant

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2016

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Pennant is a company dedicated to providing healthcare services, with a focus on life-changing service, culture, and leadership. They support independent operating subsidiaries that offer home health care, hospice, assisted living, independent living, and memory care. Their mission is to empower local leaders with resources and tools to deliver high-quality care. Pennant operates 103 home health and hospice agencies and 51 senior living communities across several U. S. states, including Arizona, California, and Texas. They emphasize a strong company culture guided by core values that prioritize customer service, accountability, and intelligent risk-taking.

📋 Description

• Act as liaison between agencies/facilities and managed care plan partners • Participate in strategic decisions and efforts related to new contracting opportunities • Maintain tools and processes supporting timely, compliant, and accurate managed care credentialing applications • Manage credentialing and re-credentialing for assigned geographic regions across the organization • Ensure compliance with applicable policies, procedures, bylaws, rules, regulations, and accreditation standards • Communicate with managed care organizations to obtain and verify credentialing requirements, submission guidelines, and status updates • Complete and submit credentialing applications accurately and on time • Coordinate with Legal, Licensing, Accounts Receivable, and Payor Admin to verify and obtain pertinent information • Maintain a comprehensive database of agency/community credentialing documents • Represent agencies/communities and the company professionally to managed care plans and external partners • Assist Managed Care Resources and the team with special contracting projects • Manage the assigned credentialing email inbox • Respond to credentialing inquiries and provide necessary information to agencies/communities and managed care organizations

🎯 Requirements

• Minimum of 3 years of credentialing experience or healthcare administrative experience • Strong organizational skills and attention to detail • Demonstrated professionalism and exceptional interpersonal skills • Ability to adhere to strict confidentiality guidelines and operate with integrity, discretion, and strong ethics • Strong written and verbal communication skills • Teamwork-oriented, self-motivated, and willing to learn and adopt new strategies • Ability to follow through with delegated tasks, assume accountability, and take initiative • Resourcefulness in problem-solving • Intermediate to advanced computer skills • Proficiency in MS Office applications, including Excel, Word, Outlook, PowerPoint, SharePoint, and Smartsheet • Proficiency with Adobe PDF • Accuracy and results orientation • Knowledge of commonly used credentialing concepts, practices, and procedures • Excellent time management and multitasking abilities • Ability to function independently with minimal direct supervision • Ability to embrace Pennant’s core values and culture • Home Health, Hospice, Personal Care, and Senior Living Community credentialing experience desired • Knowledge of Managed Care Health Plans in Tennessee, Georgia, and Alabama desired

🏖️ Benefits

• Choice of medical, dental, and vision plans • 401(k) plan with company match • Recognition through the Moments of Truth Program • Free e-courses through the Learning Management System • Training sessions and seminars • Work-life balance supporting personal well-being • Generous PTO and holidays • Professional development • Empowered, flat leadership model supported by centralized resources