working with delegated credentialing models within Medicaid, Medicare Advantage, or Commercial health plans preferred.
- High school diploma or equivalent required.
- Three (3) years of experience in healthcare contracting, provider network operations, credentialing, or related managed care functions required.
- Experience supporting provider contract administration and/or credentialing processes required.
- Experience working with contract management systems, provider databases, or workflow tracking tools required.
- Experience working with delegated credentialing models within Medicaid, Medicare Advantage, or Commercial health plans preferred.
- KNOWLEDGE/SKILLS/ABILITIES Knowledge of provider contracting lifecycle and documentation requirements. Understanding of credentialing standards (e.g., CMS, state Medicaid, NCQA, or URAC requirements). Strong organizational skills and attention to detail. Analytical skills to review documentation for completeness and compliance. Ability to manage multiple projects and deadlines simultaneously. Effective written and verbal communication skills. Ability to collaborate cross-functionally with Contracting, Credentialing, Compliance, and delegated provider entities. Proficiency in Microsoft Office and contract tracking systems.
- Knowledge of provider contracting lifecycle and documentation requirements. Understanding of credentialing standards (e.g., CMS, state Medicaid, NCQA, or URAC requirements).
- Strong organizational skills and attention to detail. Analytical skills to review documentation for completeness and compliance.
- Ability to manage multiple projects and deadlines simultaneously.
- Effective written and verbal communication skills.
- Ability to collaborate cross-functionally with Contracting, Credentialing, Compliance, and delegated provider entities.
- Proficiency in Microsoft Office and contract tracking systems.
- PHYSICAL DEMANDS Rarely (1 - 10% of the time) Occasionally (11 - 33% of the time) Frequently (34 - 66% of the time) Continually (67 – 100% of the time) CLIMB - STAIRS LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs LIFT (Knee to chest: 24"-54") 0 – 20 Lbs LIFT (Waist to Eye: up to 54") 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds BEND FORWARD at waist KNEEL (on knees) STAND WALK – LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0 - 20 pounds force) PULL (0 - 20 pounds force) SIT CARRY 2-handed, 0 - 20 pounds ROTATE TRUNK Sitting REACH - Forward MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist
- Rarely (1 - 10% of the time) Occasionally (11 - 33% of the time) Frequently (34 - 66% of the time) Continually (67 – 100% of the time) CLIMB - STAIRS LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs LIFT (Knee to chest: 24"-54") 0 – 20 Lbs LIFT (Waist to Eye: up to 54") 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds BEND FORWARD at waist KNEEL (on knees) STAND WALK – LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0 - 20 pounds force) PULL (0 - 20 pounds force) SIT CARRY 2-handed, 0 - 20 pounds ROTATE TRUNK Sitting REACH - Forward MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist