Credentialing and Payor Contracting Specialist (Full-Time)

This is a newly created role responsible for overseeing end-to-end provider and entity credentialing payor enrollment and medical staff privileging to ensure timely and accurate participation with Medicaid MCOs and commercial payors. The position also supports payor contracting by coordinating contract processes and assisting with financial and reimbursement analysis in partnership with key internal teams.

How Youll Have an Impact

Payor Credentialing & Enrollment

• Manage end-to-end credentialing and enrollment of organizational entities with Medicaid MCOs and commercial payors.
• Credential and recredential physicians advanced practice providers (APPs) and other clinical providers with all applicable payors.
• Maintain credentialing timelines to avoid lapses in participation or reimbursement.
• Serve as the primary point of contact with payors for credentialing-related inquiries follow-ups and issue resolution.
• Maintain accurate provider and entity data in credentialing systems CAQH and internal databases.
  

Hospital Medical Staff Privileging

• Provide administrative support for hospital medical staff credentialing and privileging processes.
• Compile submit and track required documentation for initial and ongoing privileges.
• Monitor expiration dates and renewal cycles to ensure continuous compliance with hospital and regulatory requirements.
• Coordinate communication between providers hospitals and internal stakeholders related to privileging status.

Payor Contract Financial Analysis Support

• Assist with the financial review and analysis of payor contracts in coordination with the Director of Revenue Cycle and the VP of Government Relations.
• Support evaluation of reimbursement methodologies rate structures and contract terms.
• Help prepare summaries comparisons and impact analyses to inform contract negotiations and strategic decision-making.
• Maintain organized records of executed payor agreements and supporting financial documentation.

Contract Intake Review & Dissemination

• Serve as the central point person for coordinating the intake tracking and dissemination of all organizational contracts (payor and non-payor).
• Manage and enforce the contract checklist process for contracts entering or exiting the organization ensuring appropriate review and approvals.
• Coordinate with legal finance compliance operations and executive leadership to ensure contracts move efficiently through the review process.
• Maintain a centralized contract repository with accurate status tracking key dates and version control.
• Support contract renewals amendments and terminations by monitoring deadlines and notifying stakeholders.
  

What Youll Need

• Bachelors degree in Accounting Finance Economics or Healthcare Administration with a strong accounting or financial analysis foundation.
• 2 years of experience in a financial analyst contracting analyst revenue cycle or healthcare financeadjacent role with demonstrable analytical responsibility. Experience in public accounting internal audit FP&A revenue integrity or healthcare finance.
• Ability to understand and communicate effectively and professionally in reading writing and speaking the English language.

Benefits

• Medical dental and vision insurance
• Health Savings Account (HSA) and Flexible Spending Account (FSA) options
• Employee Assistance Program (EAP)
• 403(b) retirement plan with company match
• Life and disability insurance
• Paid Time Off (PTO)

Make a Difference Every Day at ChildServe

• ChildServepartners with families to help children with special healthcare needs live agreatlife.
• ChildServeis a leading pediatric healthcare provider with Iowas only childrens specialty hospital offering a variety of services and programs to meet each childs unique needs.
• ChildServesfour key specialty areas include: complex medical care pediatric rehabilitation autism and behavioral health and community-based services. With a coordinated approach to care delivery services are interwoven and streamlined so families can address their childs needs in one location.
• Established in 1928 ChildServeproudly provides more than 30 pediatric specialty services to nearly 6000 children in Iowa each year.

ChildServeis committed to working with and providing reasonableaccommodationsto applicants with disabilities. To request assistance with the application process please emailemailprotected. ChildServeis an Equal Opportunity Employer.