drjobs Division Contracts and Credentialing Specialist

Division Contracts and Credentialing Specialist

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1 Vacancy
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Job Location drjobs

Phoenix - USA

Monthly Salary drjobs

Not Disclosed

drjobs

Salary Not Disclosed

Vacancy

1 Vacancy

Job Description

Position Summary

The Division Contracts and Credentialing Specialist leads the efforts in contract negotiations and analysis for Medicaid managed care and other ancillary/payor source contracts as assigned of all facilities in the division in accordance with all laws regulations and LCCA standards. Reports to the Division Controller.

Education Experience and Licensure Requirements

  • Bachelors degree in business or healthcare field from accredited college (or equivalent experience)
  • Five or more years experience in managed care contracting in the insurance or provider setting
  • Prior healthcare experience skilled nursing preferred
  • Familiar with professional community

Specific Job Requirements

  • Willing and able to travel extensively
  • Excellent verbal and written communication skills
  • Proficient with Word Excel and email
  • Able to multitask
  • Able to implement contracts at facility level
  • Knowledgeable of managed care practices and procedures as well as laws regulations and guidelines governing managed care functions in longterm care
  • Plan organize develop implement and interpret programs goals objectives policies and procedures of the managed care department

Essential Functions

  • Work closely with facilities to implement profitable managed care contracts
  • Educate divisional regional and facility staff in aspects of managed care and cost containment
  • Review contracts annually and negotiate optimal rates for contract levels
  • Serve as liaison between managed care organization and facilities to problemsolve issues and ensure costeffective services are provided and favorable outcomes obtained
  • Read write speak and understand the English language
  • Understand and follow company policies including harassment and complaint procedures
  • Practice dependable regular attendance
  • Concentrate and use reasoning skills and good judgment
  • Communicate and function in an interdisciplinary team
  • Sit stand bend lift push pull stoop walk and move intermittently during working hours

An Equal Opportunity Employer


Required Experience:

Unclear Seniority

Employment Type

Full-Time

Company Industry

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