Practitioner Mgmt Coord (US)

Mosaic Health, LLC.; Cerritos (CA); Hybrid; USD 33,000 - 61,000; Full time

Job summary

Mosaic Health is seeking a Credentialing & Enrollment Coordinator to manage provider credentialing and enrollment activities across multiple states. The role requires strong Excel skills, meticulous record-keeping, and collaboration with health plans and provider offices to ensure timely processing.

The candidate will review applications, track status, and communicate decisions while supporting audits and data validation to maintain regulatory compliance.

Qualifications

• High school diploma or equivalent required; Associate's or Bachelor's degree preferred.
• Minimum of 2 years of healthcare credentialing and/or provider enrollment experience.

Responsibilities

• Coordinate and maintain initial credentialing and recredentialing inventories to ensure timely completion and compliance.
• Review applications for completeness and accuracy.
• Outreach to providers and internal partners to obtain missing documentation.
• Track credentialing status and generate operational reports for audits.
• Communicate approvals, denials, and status updates to providers and internal stakeholders.
• Support provider enrollment activities with government and commercial payers.
• Maintain accurate provider records and respond to inquiries in a timely manner.
• Collaborate with health plans, providers, and departments to resolve credentialing issues.
• Assist with credentialing audits and data validation.

Skills

Excel proficiency

Attention to detail

Organization

Communication

Education

High school diploma or equivalent

Associate's or Bachelor's degree preferred

Tools

CAQH

PECOS

NPPES

Availity

Job description

## Practitioner Mgmt Coord (US)Applyremote type: Hybrid - Full Timelocations: Cerritos, CA: Nevada, USA: Arizona, USAtime type: Full timeposted on: Posted Yesterdayjob requisition id: M103485**Job Description Summary**The Credentialing & Enrollment Specialist is responsible for coordinating and maintaining provider credentialing and enrollment activities to ensure compliance with organizational, regulatory, and health plan requirements. This role manages initial credentialing and recredentialing inventories, supports provider enrollment processes, conducts outreach for missing documentation, communicates credentialing decisions, and serves as a liaison between providers, network partners, and internal stakeholders. The position requires strong organizational skills, attention to detail, proficiency in Microsoft Excel, and excellent written and verbal communication skills.**How will you make an impact & Requirements*** Manage and maintain assigned initial credentialing and recredentialing inventories to ensure timely completion and compliance with established turnaround times.* Review credentialing and enrollment applications for completeness and accuracy.* Conduct outreach to providers, provider groups, and internal stakeholders to obtain missing or required documentation.* Track and monitor credentialing and enrollment status through various systems and reports.* Communicate credentialing approvals, denials, and status updates to providers and internal business partners.* Support provider enrollment activities with government and commercial payers.* Maintain accurate provider records, files, and databases.* Monitor shared departmental email inboxes and respond to inquiries in a timely and professional manner.* Collaborate with network partners, health plans, provider offices, delegated entities, and internal departments to resolve credentialing and enrollment issues.* Prepare and maintain Excel spreadsheets, tracking logs, and reports for operational and audit purposes.* Ensure compliance with NCQA, CMS, state regulatory, and organizational credentialing requirements.* Assist with credentialing audits, data validation, and special projects as assigned.* Escalate complex issues and aging inventory items as appropriate.**Required Education and Experience*** High school diploma or equivalent required; Associate's or Bachelor's degree preferred.* Minimum of 2 years of healthcare credentialing and/or provider enrollment experience.* Experience working with health plans, provider groups, or managed care organizations preferred.* Knowledge of provider credentialing, recredentialing, and enrollment processes.**Knowledge, Skills, and Abilities*** Strong proficiency in Microsoft Excel, including sorting, filtering, reporting, and data management.* Excellent verbal and written communication skills.* Strong attention to detail and organizational skills.* Ability to manage multiple priorities and meet deadlines in a fast-paced environment.* Experience maintaining shared mailboxes and managing high-volume communications.* Ability to work independently and collaboratively with cross-functional teams.* Customer service oriented with strong problem-solving skills.* Knowledge of credentialing regulations, accreditation standards, and provider data management preferred.### Preferred Experience* Experience with NCQA credentialing standards.* Experience with provider enrollment systems, CAQH, PECOS, NPPES, Availity, and state Medicaid enrollment portals.* Experience supporting delegated credentialing or managed care network operations.**Compensation Range:**$24.20to$43.56*The anticipated base salary range represents the Company's good-faith estimate of the compensation it reasonably expects to pay for this position at the time of posting. Actual compensation will be determined based on factors including experience, skills, qualifications, geographic location, internal equity, and business needs.*### About UsAt CareMore Health, we provide effective Advanced Primary Care and Palliative Care by seeing the whole person — body, mind, and spirit. We do it with doctors and nurses who provide personalized and compassionate care, nationally recognized disease prevention and management programs, and healthy-living plans. It helps patients get healthier, while receiving the healthcare experience they’ve always wanted.### Who we areMosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. The Business Units which comprise Mosaic Health are multi-payer and serve nearly one million consumers across 19 states, providing them with access to high quality primary care, integrated care teams, personalized navigation, expanded digital access, and specialized services for higher-need populations. Through Mosaic Health, health plans and employers have an even stronger care provider partner that delivers affordability and superior experiences for their members and employees, including value-based primary care capacity integrated with digital patient engagement and navigation. Each of the companies within Mosaic Health provide unique offerings that together promise to improve individuals' health and wellbeing, while helping care providers deliver higher quality care. For more information, please visit www.mosaichealth.com.Mosaic Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.If you require an accommodation for the application or interview process, please let us know and we will work with you to meet your needs. Please contact [e-mail] for assistance.