Coordinator, Managed Care, Credentialing

Cardinal Health

Annapolis (MD)

On-site

USD 25,000 - 41,000

Full time

4 days ago
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Benefits offered by this job

Health insurance
Paid time off
401k Savings plan
MyFlexPay
FSAs
Disability coverage
Work-Life resources
Paid parental leave
Healthy lifestyle programs

Job summary

Cardinal Health is seeking a Coordinator, Managed Care, Credentialing to ensure active credentialing/enrollment status with all contracted payors for all groups and providers. You will maintain licensure and certifications and support enrollment activities across regions.

Responsibilities include documenting credentialing activity, monitoring licenses, coordinating provider enrollment, meeting deadlines, and collaborating with the Credentialing Supervisor to update progress.

Qualifications

  • At least three (3) years of credentialing or payer enrollment experience in a managed care or provider setting, including experience using a credentialing database.
  • Specific knowledge of the payer environment and payer issues
  • Ability to work a flexible schedule (including overtime, and weekends), as necessary.
  • Excellent customer service and communication skills.
  • Ability to work independently and as part of a team.
  • Working experience with Excel spreadsheets and Microsoft Word documents.
  • College degree or commensurate working experience in healthcare.
  • Knowledge of basic medical terminology.
  • Credentialing database experience (such as IntelliCred, E-Vips, Vistar, Cactus, Symed, etc.)

Responsibilities

  • Document and track all credentialing/enrollment, re-credentialing/re-enrollment, and hospital privileging activities within the credentialing platform
  • Maintain and monitor all licenses and certifications in the credentialing platform to ensure compliance within all regions.
  • Participate in training sessions and special projects such as learning new system workflows, completing required training, and adopting updated processes within established timeframes.
  • Coordinate provider enrollment activities (including initial enrollments or re-credentialing) for all groups and providers.
  • Ensure all facility and provider licenses and certifications are accurate and in good standing at all times.
  • Complete all forms and supporting documents required to obtain hospital privileges for physicians, as necessary.
  • Ensure that all processing and reporting deadlines are consistently achieved.
  • Meet regularly with Credentialing Supervisor and other team members to provide updates on progress and status of credentialing and enrollment matters.
  • Performs any other functions as required by management.

Skills

Credentialing experience
Payer enrollment
Customer service
Communication skills
Teamwork
Flexible schedule
Medical terminology

Education

College degree or commensurate experience in healthcare
Medical terminology knowledge

Tools

IntelliCred
E-Vips
Vistar
Cactus
Symed
Excel
Word

Job description

US-Nationwide-FIELD

Full time

20184974

Coordinator, Managed Care, Credentialing
What Managed Care contributes to Cardinal Health

Practice Operations Management oversees the business and administrative operations of a medical practice.

Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, enrollment, credentialing, and any other activity as it relates to payer interaction.

The Coordinator, Managed Care, Credentialing is responsible for ensuring an active credentialing/enrollment status with all contracted payors for all groups and providers. This position is also responsible for ensuring that all licensure is updated and active for all groups and providers.

Responsibilities
  • Responsible for documenting and tracking all credentialing/enrollment, re-credentialing/re-enrollment, and hospital privileging activities within the credentialing platform
  • Maintain and monitor all licenses and certifications in the credentialing platform to ensure compliance within all regions.
  • Participate in training sessions and special projects such as learning new system workflows, completing required training, and adopting updated processes within established timeframes.
  • Coordinate provider enrollment activities (including initial enrollments or re-credentialing) for all groups and providers.
  • Ensure all facility and provider licenses and certifications are accurate and in good standing at all times.
  • Complete all forms and supporting documents required to obtain hospital privileges for physicians, as necessary.
  • Ensure that all processing and reporting deadlines are consistently achieved.
  • Meet regularly with Credentialing Supervisor and other team members to provide updates on progress and status of credentialing and enrollment matters.
  • Performs any other functions as required by management.
Qualifications
  • At least three (3) years of experience of credentialing or payer enrollment experience in a managed care or provider setting, including experience using a credentialing database.
  • Specific knowledge of the payer environment and payer issues
  • Ability to work a flexible schedule (including overtime, and weekends), as necessary.
  • Excellent customer service and communication skills.
  • Ability to work independently and as part of a team.
  • Working experience with Excel spreadsheets and Microsoft Word documents.
  • College degree or commensurate working experience in healthcare.
  • Knowledge of basic medical terminology.
  • Credentialing database experience (such as IntelliCred, E-Vips, Vistar, Cactus, Symed, etc.)
What is expected of you and others at this level
  • Applies acquired job skills and company policies and procedures to complete standard tasks
  • Works on routine assignments that require basic problem resolution
  • Refers to policies and past practices for guidance
  • Receives general directions on standard work; receives detailed instruction on new assignments
  • Consult with supervisor or senior peers on complex and unusual problems
Anticipated Pay Range

$18.20 - $29.70

Bonus eligible

No

Benefits

Cardinal Health offers a wide variety of benefits and programs to support health and well‑being.

  • Medical, dental and vision coverage
  • Paid time off plan
  • Health savings account (HSA)
  • 401k savings plan
  • Access to wages before pay day with myFlexPay
  • Flexible spending accounts (FSAs)
  • Short- and long-term disability coverage
  • Work-Life resources
  • Paid parental leave
  • Healthy lifestyle programs

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

Headquartered in Dublin, Ohio, Cardinal Health, Inc. (NYSE: CAH) is a distributor of pharmaceuticals, a global manufacturer and distributor of medical and laboratory products, and a provider of performance and data solutions for healthcare facilities.

We are a crucial link between the clinical and operational sides of healthcare, delivering end‑to‑end solutions and data‑driving insights that advance healthcare and improve lives every day. With deep partnerships, diverse perspectives and innovative digital solutions, we build connections across the continuum of care.

With more than 50 years of experience, we seize the opportunity to address healthcare's most complicated challenges — now, and in the future.

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