Amity Foundation · 1 month ago
Contracting and Credentialing Specialist (Contractor) - Contracting Dept.
United States
Part-time, Contract
Remote
Mid Level
$35/hr - $35/hr
3+ years expAmity Foundation is dedicated to the inclusion and habilitation of marginalized individuals. The Contracting and Credentialing Specialist is responsible for managing contracting and credentialing activities with insurance companies and Medicaid agencies, ensuring accurate submissions and maintaining compliance throughout the process.
CommunitiesNon ProfitSocial Impact
Responsibilities
Work closely with Grants, Contracts and Development team; Chief Operating Officers; Program Manager; and Finance to review current plans and design a timeline for additional plans
Make initial contact with provider enrollment for each plan
Oversee the application and credentialing process
Prepare, submit and track all contracting paperwork, credentialing applications and recredentialing files for all providers and facilities with commercial insurance carriers and Medicaid agencies
Serve as the primary point of contact for credentialing activities, ensuring accuracy, timelines and compliance requirements
Monitor credentialing timelines, proactively follow-up through the approval and contracting process
Maintain an organized tracking system of credentialing statuses, contracting progress, rate agreements, and renewal deadlines
Attend regular meetings to provide regular reports to leadership regarding credentialing/enrollment completions, contracting process and outstanding issues
Develop effective working relationships with credentialing and contracting representatives to streamline processes
Work with the Amity services faculty in Pima County to gather and verify specific information needed for applications in Arizona
Work with the Amity Enhance Care Management and Community Supports faculty to gather and verify specific information needed for applications in California
Ensure that all draft contracts are sent to and reviewed by relevant Amity services, finance, legal, people operations, data and executive teams
Ensure that all fully executed contracts are uploaded to the Amity contracts repository and are also sent to all relevant Amity services, finance, legal, people operations, data and executive teams
Stay up to date on Medicaid guidelines, commercial insurer requirements and industry best practices related to credentialing and contracting
Perform other related duties as assigned
Qualification
Required
Bachelor's degree in business administration, healthcare management or related field preferred
3+ years of work experience in credentialing and contracting within healthcare
Proven ability to successfully manage provider credentialing workflows and securing insurer contracts
Strong organizational skills with the ability to manage multiple credentialing files and contracts simultaneously
Excellent communication skills with persistence, assertiveness and a results-driven approach
Proficiency with Microsoft Office Suite and credentialing and contracting portals
Exceptional organizational and project management skills, with the ability to independently coordinate and lead multiple projects simultaneously focusing on quality and project follow-through
Ability to establish effective working relationships with staff, groups, agencies, officials, departments, and boards and manage expectations and priorities from various partners
Ability to interpret rules, regulations, guidelines, and legislation as they pertain to credentialing and contracting responsibility
Ability to retain and recall information regarding accounting systems and reporting requirements
Strong judgement in regard to how to manage sensitive topics
Analytical, database and reporting skills along with ability to prepare recommendations for courses of action
Ability to craft or update policies and procedures with a sharp eye for accuracy and detail
Ability to frame issues and communicate technical, budgetary, and program details across all functions and to various partners
Confidence to ask pertinent questions to grasp concepts quickly and think beyond specific tasks
Superb interpersonal skills with a comfort working across diverse teams and handling senior leaders and use good judgement to resolve issues
Excellent written and verbal communication skills
Flexibility and ability to learn and develop new skills on the job
An ability to balance time efficiently, adhere to strict deadlines and multi-task in a fast-paced environment
Highly organized, detail-oriented, and committed to quality
Proactive problem solver and a self-starting individual
Excel at both working collaboratively and independently
Flexible, open, positive, and collaborative personality
Preferred
Highly detail-oriented with zero tolerance for errors in credentialing documentation
Self-motivated, disciplined, and comfortable in deadline-driven environment
Understanding of California Advancing and Innovating Medi-Cal (Cal-AIM) for the justice-involved population
Understanding of the Arizona Health Care Cost Containment System (AHCCCS) for behavioral health services
Understanding of regional community-level needs with regards to social services for the justice-involved population
Company
Amity Foundation
Amity Foundation is a non-profit agency that serves individuals, families and children affected by recidivism, homelessness and addiction.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
$4MKey Investors
U.S. Department of Labor
2024-07-02Grant· $4M
Leadership Team
D
Doug Bond
Chief Executive Officer
Recent News
PR Newswire
2025-05-07
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