Managed Care Coordinator & Credentialing Specialist

RiseMe; Visalia (CA); On-site; USD 36,000 - 43,000; Full time

Job summary

RiseMe is seeking a Managed Care Technician to support the Managed Care department, focusing on contracting, provider enrollments with payors, and IPA relationships. You will manage day-to-day interactions with Health Plans, handle credentialing tasks, enrollment filings, and reporting across membership trends and QA initiatives.

The role requires healthcare administration experience, strong communication, and proficiency with Word, Excel, and PowerPoint.

Qualifications

• Minimum two years of healthcare administration or relevant experience.
• Associate’s Degree preferred; high school diploma or GED with relevant healthcare knowledge acceptable.
• Strong written and verbal communication, math, and technical skills.

Responsibilities

• Primary IPA and Health Plan interactions, addressing membership, credentialing, and referral issues.
• Process monthly membership attributions and analyze membership trends.
• Produce and validate monthly reports on membership trends, market share, and QA initiatives.
• Assist with initial provider credentialing and reappointment processes.
• Facilitate provider enrollments with health plans, Medi-Cal, Medicare, and payers.
• Ensure attendance per Attendance and Absenteeism Policy and adapt to multiple RiseMe locations.

Skills

Healthcare administration

Communication skills

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Education

Associate's Degree preferred

High School Diploma or GED

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

RiseMe is seeking a Managed Care Technician to support the Managed Care department, focusing on contracting, provider enrollments with payors, and IPA relationships. You will manage day-to-day interactions with Health Plans, handle credentialing tasks, enrollment filings, and reporting across membership trends and QA initiatives.

The role requires healthcare administration experience, strong communication, and proficiency with Word, Excel, and PowerPoint.