Contracting and Credentialing Manager

Neurotech, LLC; Waukesha (WI); Hybrid; USD 85,000 - 120,000; Full time

Benefits offered by this job

401(k)

401(k) matching

AD&D insurance

Employee assistance program

Free parking

Health insurance

Health savings account

Life insurance

Paid time off

Vision insurance

Job summary

Neurotech, LLC is seeking a Contracting and Credentialing Manager to lead network, payer, facility, physician contracting, and credentialing efforts. The role coordinates enrollment updates, site surveys, and audits while maintaining strict confidentiality and HIPAA compliance.

The position requires collaboration with leadership and multiple departments to pursue contracting opportunities and ensure accurate records across systems.

Qualifications

• Manage contracting, credentialing, enrollment and related business development activities.
• Coordinate network, CMS/Medicaid enrollment, and site surveys.
• Ensure HIPAA privacy and security requirements are met across processes.

Responsibilities

• Identify insurance network opportunities and coordinate contracting processes.
• Prepare, review, and track contract and enrollment documentation.
• Coordinate credentialing for physicians and facilities and manage renewals.
• Lead site surveys and respond to audits with leadership input.
• Maintain accurate contract and credentialing records and communicate updates to Sales.

Skills

Contracting

Credentialing

HIPAA compliance

Healthcare regulations

Project coordination

Interdepartmental collaboration

Audit support

Tools

NPPES

CMS enrollment tools

EHR systems

Job description

The Contracting and Credentialing Manager manages Neurotech’s network, payer, facility, physician contracting, credentialing, and related business development activities. This role identifies and pursues contracting opportunities; coordinates contract preparation, review, execution, renewals, and required notifications; and maintains accurate credentialing, enrollment, and accreditation records. The Manager works collaboratively with company leadership and relevant departments, maintains strict confidentiality, and handles protected health information in accordance with applicable privacy requirements, including HIPAA.

Key Responsibilities

• Insurance Network, and Payer Contracting
• Identify insurance and network plans for potential participation, including PPOs, HMOs, self-funded employers, and ACOs.
• Initiate and coordinate network participation applications and contract processes, including completing forms and communicating with appropriate contacts.
• Track applications, deliverables, and follow-ups through contract execution or formal declination; maintain detailed notes and follow-up schedules.
• Review proposed contracts to identify questions, concerns, or potential issues and bring them to the appropriate leader for resolution.
• Coordinate required signatures and follow up on counter-signatures, revalidations, renewals, and other contract updates.
• Maintain organized electronic and paper contract files and provide periodic updates to Sales regarding new contracts.
• Coordinate required payer, CMS, Medicaid, and other enrollment-profile updates, including changes to office locations and personnel, as applicable.
• Prepare and coordinate Medicare site surveys at Neurotech locations, including required materials, tech training, and communication with the surveyor.
• Troubleshoot contract and enrollment issues where identified by the billing department, including initial outreach, project monitoring, and post-hoc corrections or amendments to ensure proper claims processing.
• Monitor relevant healthcare developments and share notable changes with company leadership.

Facility Contracting and Service Opportunities

• Support facility contracting efforts with hospitals and other potential service partners, including acute-care and rural hospitals, long-term care and intermediate-care facilities, mental health facilities, and other healthcare organizations.
• Prepare facility-specific contract materials at the request of Sales and Operations and assist with proposals, documentation, and follow-up communications.
• Manage contract negotiation with the hospital site, including redline submission and response, meetings with key stakeholders, and analysis of any proposed changes.
• Coordinate collection of credentialing and other required information from facilities and help move agreements through finalization.
• Identify, create, and finalize amendments to existing facility contracts, including annual price increases and term updates as needed.
• Monitor and proactively renew hospital contracts prior to expiration.
• Maintain a means of accurate documentation and communication with Finance of contract rates and terms.
• Route contracting questions and service issues to the appropriate company contacts and coordinate resolution.

Physician and EEG Technologist Contracting and Credentialing

• Manage credentialing for Neurotech interpreting physicians in accordance with applicable Joint Commission standards and company requirements.
• Identify physician coverage needs and perform outreach and coordination of new contracted physician candidates.
• Prepare and maintain interpreting-physician contracts, and coordinate renewals, peer-review activities, and re-credentialing.
• Schedule, prepare, and run bimonthly Credentialing Committee meetings and correspondence.
• Oversee the credentialing of contracted physicians rendering services at contracted facilities.
• Assist physicians with obtaining state licenses where applicable.
• Track and verify required malpractice insurance documentation for reading physicians, including coverage through the employer or Neurotech, as applicable.

Joint Commission Accreditation and Compliance Support

• Conduct exclusion screening and license verification on both a pre-service basis for new ordering physicians and on a monthly basis for all Neurotech employees, vendors, contracted providers, facilities, and ordering physicians.
• Manage the coordination and response of Neurotech on all audits relating to health insurance, credentialing, and contracted entities.
• Assist with Joint Commission accreditation activities in coordination with leadership and relevant staff.
• Manage all aspects of credentialing for TJC accreditation and activities.
• Help organize and track post-survey activities, Evidence of Standards Compliance (ESC), Intracycle Monitoring (ICM), Focused Standards Assessments (FSA), and other required follow-up.
• Maintain accurate records and support related accreditation documentation.

General Contract and Administrative Support

• Keep NPPES information current and coordinate other required updates, renegotiations, and notifications under applicable contracts.
• Help ensure providers or clients are notified of required changes, including re-enrollment, office or staff changes, and liability insurance updates.
• Coordinate with the malpractice insurance broker and appropriate internal contacts regarding insurance documentation and coverage needs.
• Maintain strict confidentiality of company, provider, and patient information; handle protected health information in accordance with HIPAA and applicable company policies.
• Keep leadership informed of significant contracting, credentialing, research, accreditation, and business-opportunity developments.
• Perform other related duties as assigned.
• 401(k)
• 401(k) matching
• AD&D insurance
• Employee assistance program
• Free parking
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Work Location: Hybrid remote in Waukesha, WI 53188