Managed Care Credentialing Lead | Compliance & Contracts

Deercreekseniorliving; Northern (KY); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision plans

401(k) with match

Generous PTO

Professional development

Free e-courses

Job summary

Pennant Services is seeking a Managed Care Credentialing Resource to act as liaison between Agencies/Facilities and managed care plan partners, managing credentialing for our home health, hospice, personal care, and senior living communities.

The role requires at least 3 years of credentialing experience and strong organizational and communication skills to ensure compliant, timely submissions and to maintain a credentialing database.

Qualifications

• 3+ years of credentialing experience or healthcare administrative experience.
• Strong organizational skills and attention to detail.
• Demonstrated professionalism and exceptional interpersonal skills.
• Ability to adhere to strict confidentiality guidelines and operate with integrity.
• Strong written and verbal communication skills.
• Teamwork-oriented, self-motivated with a willingness to learn and adopt new strategies.
• Proficiency in MS Office applications (Excel, Word, Outlook, PowerPoint, SharePoint, Smartsheet), along with Adobe PDF.
• Knowledge of credentialing concepts, practices, and procedures.
• Excellent time management and multi-tasking abilities.
• Ability to function independently with minimal supervision and embrace Pennant's core values.

Responsibilities

• All aspects of credentialing and re-credentialing for geographic regions across the organization.
• Ensure full compliance with policies, procedures, bylaws, rules, and regulations.
• Coordinate with managed care organizations to verify requirements and submission guidelines.
• Ensure credentialing applications are completed accurately and submitted on time.
• Coordinate with Legal, Licensing, Accounts Receivable, and Payor Admin to obtain pertinent information.
• Maintain a comprehensive database of Agency/Community credentialing documents.
• Represent agencies and company professionally to managed care plans and external partners.
• Assist with special contracting projects and manage the assigned credentialing email inbox.
• Serve as liaison between Agencies/Communities and managed care organizations regarding credentialing matters.

Skills

Credentialing

Healthcare administration

MS Office proficiency

Interpersonal skills

Tools

Excel

Word

Outlook

PowerPoint

SharePoint

Smartsheet

Adobe PDF

Job description

Pennant Services is seeking a Managed Care Credentialing Resource to act as liaison between Agencies/Facilities and managed care plan partners, managing credentialing for our home health, hospice, personal care, and senior living communities.

The role requires at least 3 years of credentialing experience and strong organizational and communication skills to ensure compliant, timely submissions and to maintain a credentialing database.