Contracting and Credentialing Specialist – Contractor

This is a fully remote position, open to applicants in Arizona, +1 more state.

📋 Description

• Oversee the contracting and credentialing processes with commercial insurance providers, managed care organizations, and Medicaid agencies.

• Manage the entire workflow of provider enrollment, applications, credentialing, and contract finalization.

• Ensure the accurate submission of all applications and actively track their progress.

• Act as the main point of contact during contract negotiations.

• Maintain consistent follow-up to accelerate the approval and activation of contracts.

• Collaborate closely with the Grants, Contracts, Development team, Chief Operating Officers, Program Manager, and Finance to assess current plans.

• Initiate contact with provider enrollment for each respective plan.

• Prepare, submit, and monitor all necessary contracting documents, credentialing applications, and recredentialing files for providers and facilities.

• Track credentialing timelines and proactively follow up throughout the approval and contracting phases.

• Maintain a systematic tracking system for credentialing statuses, contracting progress, rate agreements, and renewal deadlines.

• Attend regular meetings to present updates to leadership regarding credentialing/enrollment completions, contracting processes, and any outstanding issues.

• Cultivate effective working relationships with credentialing and contracting representatives.

• Collaborate with the Amity services faculty in Pima County to collect and verify essential information for applications in Arizona.

• Partner with the Amity Enhanced Care Management and Community Supports faculty to gather and confirm specific information needed for applications in California.

• Ensure that all draft contracts are sent for review to the relevant Amity services, finance, legal, people operations, data, and executive teams.

• Guarantee that all fully executed contracts are uploaded to the Amity contracts repository and distributed to all pertinent teams.

• Stay informed about Medicaid guidelines, commercial insurer requirements, and best practices in credentialing and contracting.

⛳️ Requirements

• A bachelor’s degree in business administration, healthcare management, or a related field is preferred.

• A minimum of 3 years of experience in credentialing and contracting within the healthcare sector.

• Demonstrated ability to effectively manage provider credentialing workflows and secure insurance contracts.

• Strong organizational abilities to handle multiple credentialing files and contracts simultaneously.

• Excellent communication skills characterized by persistence, assertiveness, and a results-oriented mindset.

• Proficient in Microsoft Office Suite and credentialing and contracting platforms.

• Highly attentive to detail with a zero tolerance for errors in credentialing documentation.

• Self-motivated and disciplined, thriving in a deadline-driven environment.

• Knowledge of California Advancing and Innovating Medi-Cal (Cal-AIM) for justice-involved populations.

• Understanding of the Arizona Health Care Cost Containment System (AHCCCS) for behavioral health services.

• Awareness of community-level social service needs for justice-involved populations.

• Within 90 days of hire, documentation of participation in required trainings for Los Angeles County and Pima County as applicable.

• Willingness to participate in additional required trainings.

• Exceptional organizational and project management skills, capable of independently coordinating and leading multiple projects with a focus on quality and follow-through.

• Ability to build effective working relationships with staff, agencies, officials, departments, and boards while managing expectations and priorities from various partners.

• Capability to interpret rules, regulations, guidelines, and legislation related to credentialing and contracting.

• Proficient in retaining and recalling information pertinent to accounting systems and reporting requirements.

• Strong judgement regarding the management of sensitive topics.

• Analytical skills with database and reporting experience, along with the ability to make recommendations for action.

• Competence in crafting or updating policies and procedures with a keen eye for accuracy and detail.

• Exceptional organizational and project management skills, with the ability to independently coordinate and lead multiple projects simultaneously with a focus on quality and project follow-through.

• Ability to frame issues and effectively communicate technical, budgetary, and program details across all functions and to various partners.

• Confidence to ask relevant questions to quickly grasp concepts and think beyond specific tasks.

• Excellent interpersonal skills, comfortable working across diverse teams and interacting with senior leaders while exercising sound judgement to resolve issues.

• Superior written and verbal communication capabilities.

• Flexibility and eagerness to learn and develop new skills on the job.

• Ability to efficiently balance time, adhere to strict deadlines, and multitask in a fast-paced environment.

• Highly organized, detail-oriented, and dedicated to quality.

• Proactive problem solver and self-starter.

• Proficient in both collaborative and independent work environments.

• A positive, flexible, and collaborative personality.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and training.

• Supportive work environment that encourages collaboration and innovation.

• Flexible work arrangements to promote work-life balance.