Source Job

• Lead and supervise credentialing support staff, ensuring quality, accuracy, and timely processing of credentialing and enrollment tasks.
• Oversee provider credentialing, licensure, and internal enrollment with Medicare, Medicaid, Managed Care, and Commercial Plans.
• Maintain provider rosters, monitor license and certification renewals, and ensure compliance with regulatory and internal standards.

At Better Life Partners, we provide what it takes to heal from addiction. Wherever. Whenever. By combining virtual and in-person counseling, community support, and medication access.

The Provider Enrollment Specialist is responsible for timely and effectively enrolling practitioners in health plans. The Specialist will monitor progress, ensure timeliness of enrollment completion, and provide updates. The Specialist will maintain accurate provider profiles in IntelliCred and CAQH.

Pediatrix Medical Group is one of the nation’s leading providers of specialized health care for women, babies and children since 1979.

• Lead the full credentialing lifecycle for new and existing providers and practice locations including Medicare and Medicare Advantage plans.
• Ensure CAQH profiles are complete, current, and accurately reflect provider credentials and practice information.
• Assess current credentialing processes, identify inefficiencies, and implement improvements using Airtable, automation tools, and best practices.

Sailor Health is on a mission to solve the mental health crisis among older adults, building the platform for senior mental health.

• Provides data management support services to Dignity Health’s CI/ACO Networks, Employer Relations and Valued Based Operations (VBO).
• Within the Salesforce platform, this individual gathers and maintains accurate provider data, performs periodic provider data reconciliations with multiple data sources.
• Maintains and transmits fee schedules, as necessary, to third-party administrators (TPA's) and other appropriate stakeholders.

Dignity Health MSO builds a system-wide integrated physician-centric, full-service management service organization structure. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers.

• Ensuring providers are credentialed in a timely manner by monitoring the submission process.
• Monitoring submission processes, updating protocols, and managing Virtual Assistants/BPO.
• Communicating with payors and conducting regular reviews to validate internal credentialing data.

Grow Therapy aims to be the trusted partner for therapists growing their practice, and patients accessing high-quality care. They are a three-sided marketplace that empowers providers, augments insurance payors, and serves patients and have empowered more than ten thousand therapists.

Manage contracting and credentialing activities with insurance companies and Medicaid agencies. Oversee the provider enrollment, application, and credentialing process. Serve as the point of contact for contract negotiations and expedite approvals.

Amity Foundation is a safe place where people can change in an environment that fosters trust; where new values can be formed, responsibility developed, and lasting relationships built.

• Be the primary point of contact for all providers.
• Provide professional, accurate and timely responses to all provider inquiries.
• Maintain a current knowledge of all contract requirements and objectives.

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans.

• Assists with medical record documentation requests and leverages medical management system to initiate case and/or authorization to support clinical processes.
• Conducts fax and telephonic outreach; and written communications to members and/or providers to communicate status of UM/CM processes.
• Actively participates in supporting department compliance and performance through administrative activities such as report monitoring/distribution, and other tasks as assigned by leadership.

Capital Blue Cross promises to go the extra mile for their team and community. Employees consistently vote it one of the “Best Places to Work in PA”.

• Ensure adherence to payer requirements and internal compliance standards.
• Support audit readiness, reduce denials, and improve claim resolution.
• Maintain payer setup and readiness including fee schedules.

Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services, serving thousands of clients.

Acts as key point of contact for the processing of enrollment applications for all providers. Works with System Credentialing and local medical staff contacts. Responsible for completing the ongoing review and attestation of all Munson Healthcare provider enrollment records.

Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents.

Oversee the operations of the Imagine Pediatrics Onboarding, Credentialing, Licensing, and Enrollment Department. Develop and train on policies and procedures, workflows, and training documentation for the team. Manage Delegated Credentialing arrangements - implementation and audit – as well as ongoing Delegated partnerships with health plans.

Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs.

• Conduct outreach to providers to gather accurate pricing and market data.
• Become an expert in the provider landscape for your assigned market or service category.
• Build and maintain comprehensive provider guides that support internal teams and member-facing resources.

Sidecar Health is redefining health insurance with a mission to make excellent healthcare affordable and attainable. The company is made of passionate people from various backgrounds, united by the desire to fix the healthcare system.