Managed Care Credentialing Specialist - Full Time

Deercreekseniorliving; Eagle (ID); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision plans

401(k) with match

Professional development

Learning management courses

Generous PTO

Job summary

Pennant Services is seeking a Credentialing Resource to manage initial and re-credentialing for home health, hospice, personal care, and senior living facilities. The role requires organizing, coordinating with internal teams, and ensuring timely submissions across managed care networks.

The candidate should have 3+ years in credentialing, strong communication skills, and a commitment to accuracy and confidentiality within a growing health services organization.

Qualifications

• 3+ years of credentialing experience or healthcare admin background.
• Demonstrated professionalism and exceptional interpersonal skills.
• Ability to maintain strict confidentiality and high ethics.

Responsibilities

• Manage initial credentialing and re-credentialing across assigned regions.
• Coordinate with Legal, Licensing, AR, and Payor Admin for data and guidelines.
• Communicate with managed care plans to verify requirements and deadlines.
• Maintain a comprehensive credentialing documents database and inbox.
• Represent Agencies/Communities professionally to managed care plans.

Skills

Credentialing

Organizational skills

Interpersonal skills

Written and verbal communication

Time management

Confidentiality & ethics

MS Office suite

SharePoint/Smartsheet

Adobe PDF

Tools

MS Office Suite

SharePoint

Smartsheet

Adobe PDF

Job description

JOB SUMMARY

Acts as the liaison between our Agencies/Facilities and our managed care plan partners. Participates in strategic decisions and efforts as they pertain to new contracting opportunities, maintains tools and processes to support the completion of timely, compliant, and accurate managed care credentialing applications. A qualified candidate will have a minimum of three years of experience in credentialing. The Managed Care Credentialing Resource will play a vital role in ensuring that our organization maintains compliance with all credentialing requirements set forth by managed care organizations. This individual will be responsible for managing the credentialing process for Pennant Home Health, Hospice, Personal Care Agencies, and Senior Living Facilities within our organization, ensuring that they meet the necessary qualifications and standards to participate in various managed care networks. The ideal candidate will have a strong understanding of credentialing procedures, excellent organizational skills, and the ability to collaborate effectively with internal and external stakeholders.

DUTIES & RESPONSIBILITIES

This full-time position reports to the Director of Managed Care and is responsible for all aspects of credentialing and re-credentialing for those geographic regions assigned across the organization. Works independently to ensure full compliance with all applicable policies, procedures, bylaws, rules, and regulations, accreditation standards, and regulations for the processing of applications for initial credentialing and re-credentialing. Communicate with managed care organizations to obtain and verify credentialing requirements, submission guidelines, and status updates. Ensure that all credentialing applications are completed accurately and submitted in a timely manner to meet managed care organization deadlines. Coordinates with our Legal, Licensing, Accounts Receivable, and Payor Admin to verify and obtain pertinent information. Maintain a comprehensive database of Agency/Community credentialing documents. Expected to represent our Agencies/Communities and company professionally to all managed care plans and external partners. Assist Managed Care Resources and team with special contracting projects as assigned. Manage the assigned credentialing email inbox. Serve as a liaison between our Agencies/Communities and managed care organizations regarding credentialing matters, responding to inquiries, and providing necessary information as needed.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

JOB REQUIREMENTS (Education, Experience, Knowledge, Skills & Abilities)

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 the utmost integrity, discretion, and strong sense of ethics. Strong written and verbal communication skills required. Teamwork-oriented, self-motivated with a willingness to learn and adopt new strategies. Able to follow through with delegated tasks, assume accountability, and take initiative in all aspects of the role. Resourcefulness in problem-solving. Intermediate to advanced computer skills, including proficiency in MS Office applications (Excel, Word, Outlook, PowerPoint, SharePoint, Smartsheet), along with Adobe PDF. Dedicated to accuracy and results. Knowledge of commonly used credentialing concepts, practices, and procedures. Excellent time management and multi-tasking abilities. Demonstrated ability to function independently with minimal direct supervision. Ability to embrace Pennant's core values and culture.

DESIRED QUALIFICATIONS

Home Health, Hospice, Personal Care and Senior Living Community credentialing experience. Knowledge of Managed Care Health Plan in Tennessee, Georgia, and Alabama.

ADDITIONAL INFORMATION

We are committed to providing a competitive Total Rewards Package that meets our employees' needs. From a choice of medical, dental, and vision plans to retirement savings opportunities through a 401(k) plan with company match and various other benefits, we offer a comprehensive benefits package. We believe in great work, and we celebrate our employees' efforts and accomplishments both locally and companywide, recognizing people daily through our Moments of Truth Program. In addition to recognition, we believe in supporting our employees' professional growth and development. We provide employees a wide range of free e-courses through our Learning Management System as well as training sessions and seminars.

Compensation: Based on experience.

WHY JOIN US AT PENNANT SERVICES

At Pennant Services, we don't just manage—we lead like owners. Our unique culture is built around empowerment, accountability, and growth. We invest in people who are ready to build and own their impact.

What sets us apart:

• Empowered, flat leadership model supported by centralized resources
• A work-life balance that promotes personal well-being
• Complete benefits package: medical, dental, vision, 401(k) with match
• Generous PTO, holidays, and professional development
• A culture built around our core values—CAPLICO: Customer Second Accountability Passion for Learning Love One Another Intelligent Risk Taking Celebrate Ownership

ABOUT PENNANT

Learn more at: www.pennantgroup.com

The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at http://www.pennantgroup.com. Pennant Group is one of the most dynamic and progressive companies in the rapidly expanding senior living, home health, hospice, and home care industries. Affiliates of Pennant now operate more than 250 senior living, home health, hospice, and home care operations across 16 states and we are growing! These operations have no corporate headquarters or traditional management hierarchy. Instead, they operate independently with support from the “Service Center,” a world-class service team that provides the centralized clinical, legal, risk management, HR, training, accounting, IT and other resources necessary to allow on-site leaders and caregivers to focus squarely on day-to-day care and business issues in their individual agencies. More information about Pennant is available at https://pennantgroup.com/. Something else that sets us apart from other companies is the quality of our most valuable resources – our people! We are dedicated to living out our culture as defined by our core values, CAPLICO: Customer Second Accountability Passion for Learning Love One Another Intelligent Risk Taking Celebrate Ownership By incorporating these principles at all levels of our organization, our employees feel valued and excited about their impact on our service center team members and operational partners. Our culture fosters excellence both personally and professionally and promotes development that leads to continued success.

We are an equal opportunity employer committed to ensuring that all conditions and privileges of employment, including recruitment, hiring, evaluation, transfer, promotion, discipline, determination of compensation and/or benefits, and termination of employment, for all job classifications, are based on qualifications and work record. No employment decision is made, nor do we discriminate, on the basis of race, color, religion, creed, sex/pregnancy, sexual orientation, gender identity, gender expression, age, national origin, ancestry, citizenship, veteran status, or disability.