Managed Care Credentialing Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Serve as a liaison between agencies/facilities and managed care plan partners.

• Engage in strategic decision-making and initiatives concerning new contracting opportunities.

• Maintain tools and processes that ensure timely, compliant, and accurate managed care credentialing applications.

• Oversee credentialing and re-credentialing for designated geographic regions throughout the organization.

• Guarantee adherence to relevant policies, procedures, bylaws, rules, regulations, and accreditation standards.

• Communicate with managed care organizations to gather and confirm credentialing requirements, submission guidelines, and updates on status.

• Accurately complete and submit credentialing applications within deadlines.

• Collaborate with Legal, Licensing, Accounts Receivable, and Payor Administration to verify and acquire necessary information.

• Sustain a thorough database of agency/community credentialing documents.

• Professionally represent agencies/communities and the organization to managed care plans and external partners.

• Assist Managed Care Resources and the team with specialized contracting projects.

• Oversee the designated credentialing email inbox.

• Address credentialing inquiries and provide essential information to agencies/communities and managed care organizations.

⛳️ Requirements

• At least 3 years of experience in credentialing or healthcare administration.

• Excellent organizational skills and a keen attention to detail.

• Proven professionalism and outstanding interpersonal abilities.

• Capacity to uphold stringent confidentiality standards while operating with integrity, discretion, and strong ethics.

• Strong written and verbal communication skills.

• Team-oriented, self-driven, and eager to learn and implement new strategies.

• Ability to follow through on delegated tasks, take responsibility, and show initiative.

• Resourceful in solving problems.

• Intermediate to advanced proficiency in computer skills.

• Proficient in MS Office applications, including Excel, Word, Outlook, PowerPoint, SharePoint, and Smartsheet.

• Familiarity with Adobe PDF.

• Strong focus on accuracy and results.

• Understanding of commonly utilized credentialing concepts, practices, and procedures.

• Excellent time management and multitasking skills.

• Ability to work independently with minimal direct supervision.

• Willingness to embrace Pennant’s core values and culture.

• Experience in credentialing for Home Health, Hospice, Personal Care, and Senior Living Communities is preferred.

• Familiarity with Managed Care Health Plans in Tennessee, Georgia, and Alabama is a plus.

🏝️ Benefits

• Selection of medical, dental, and vision plans.

• 401(k) plan with company matching.

• Recognition through the Moments of Truth Program.

• Access to free e-courses via the Learning Management System.

• Participation in training sessions and seminars.

• Support for work-life balance promoting personal well-being.

• Generous paid time off and holiday benefits.

• Opportunities for professional development.

• Empowered, flat leadership structure backed by centralized resources.