Contracts and Payor Credentialing Specialist

Sevita; Minneapolis (MN); Remote; USD 65,000 - 85,000; Full time

Benefits offered by this job

Full-time position

401(k) with company match

Paid time off and holidays

Career development opportunities

Job summary

Sevita’s NeuroRestorative team is seeking a Contracts and Payor Specialist for a remote, nationwide role. You will identify and secure insurance contracts, review existing agreements, and credential clinicians for enrollment.

Work closely with Program Directors and the Director of Contracts and Payor Engagement to expand funding opportunities and secure favorable terms. The role also involves communicating contract specifics to internal teams, supporting the Single Case Agreement process, and

Qualifications

• Bachelor’s degree preferred in Rehabilitation Administration, Business Administration or related field.
• 3–5 years’ experience with contracts, managed care, and health insurance preferred.
• Prior credentialing experience a must.

Responsibilities

• Identify and secure public and private insurance contracts; review and organize contracts.
• Credentialing and enrollment application requirements.
• Lead negotiations with payors and describe programs to contract sources.

Skills

Contract management

Credentialing

Health insurance knowledge

Education

Bachelor’s degree (Rehabilitation Admin/Business Admin or related)

Tools

CAQH

Credentialing software

Job description

NeuroRestorative, a part of the Sevita family, provides rehabilitation services for people of all ages with brain, spinal cord and medically complex injuries, illnesses and other challenges. In a variety of locations and community-based settings, we offer a range of programs, including vocational and therapy programs, day treatments, and specialized services for infants, children, adolescents, Military Service Members and Veterans.

Contracts and Payor Specialist - Remote

The Contracts and Payor Specialist is responsible for identifying and securing public and private insurance contracts; reviews and organizes existing contracts. Assists with the development of potential relationships with strategic partners and creates measurable business results for various markets. Responsible for credentialing of licensed clinicians.

Contracting and Credentialing

• Works in partnership with Program Directors and Director of Contracts and Payor Engagement to ensure consistency and secure public and private insurance contracts
• Analyzes and monitors financial aspects of existing contracts and maintains original documentation of all contracts
• Completes contract related credentialing and enrollment application requirements
• Identifies, contacts, and creates relationships with potential payors that result in new contracts and increased funding possibilities for program participants
• Conducts rate and contract negotiations
• Describes Client programs to potential contract sources
• Communicates with state directors, and state operating/marketing staff regarding contract specifics. Ensures commitments to participants, family, referral sources and payors are met
• Maintains database of licenses, accreditation forms, financial and organizational information for the purpose of efficient and timely enrollment application
• Oversees Single Case Agreement process within the Admissions Teams. May take lead in difficult single case negotiation

Other Duties

• Communicates contract executions and requirements to all internal departments
• Facilitates resolution of contract related issues with billing and collections team
• Performs other related duties, projects, and activities as required

Qualifications

• Bachelor’s degree in Rehabilitation Administration, Business Administration or related field preferred
• Three to five years’ experience with contracts, managed care, and health insurance related industry preferred
• Prior credentialing experience a must
• A reliable, responsible attitude and a compassionate approach
• A commitment to quality in everything you do
• Experience with CAQH a plus

Why Join Us?

• Full time position
• Full compensation/benefits package for employees working 32+ hours/week
• 401(k) with company match
• Paid time off and holiday pay
• Rewarding work, impacting the lives of those you serve, working alongside a great team of coworkers
• Enjoy job security with nationwide career development and advancement opportunities

Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face.

We’ve made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S.

As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.