Division Contracts and Credentialing Specialist
Division Contracts and Credentialing Specialist
Posted on :
05-04-2025
Employer Active
1 Vacancy
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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
Key Skills
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