Credentialing Specialist-Managed Care

Job Description

Job Description

Responsibilities

At VHC Health, every role contributes to exceptional care, better outcomes, and stronger communities.  

In addition to your base compensation, VHC Health offers a comprehensive benefits package, including medical, dental, and vision coverage (subject to eligibility requirements), as well as additional wellness and retirement benefits designed to support our employees and their families. 

VHC Health is committed to wage transparency and equitable pay practices. The compensation offered for this position—whether expressed as an annual salary or hourly rate—is determined based on a variety of legitimate, non-discriminatory factors. These factors include, but are not limited to, a candidate’s qualifications, relevant training and experience, skill level, shift differentials (where applicable), internal equity, and current market conditions. 

The posted hiring range reflects the range VHC Health, in good faith, believes is appropriate for this role at the time of posting. This range may be adjusted in the future based on business needs or market changes. No portion of compensation is considered earned until it is vested and determined in accordance with the terms of applicable policies and benefit plans. The availability and amount of any bonuses, incentives, or other benefits are subject to the terms of those plans and may be modified at the sole discretion of VHC Health, in accordance with applicable law. 

VHC Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law. 

VHC Health maintains a drug-free workplace. The unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited at all VHC Health locations. 

Qualifications

Purpose & Scope:

Responsible for physician and advanced practice provider insurance plan credentialing and enrollment. Works with credentialing and contracting associates with government and commercial payers to expedite effective dates of insurance participation for new providers. Maintains data in various systems to ensure accuracy and successful re-credentialing. Assists with facility credentialing as necessary.

Education:

Bachelor's degree in a healthcare related field is preferred.

Experience:

One year of insurance plan credentialing experience in a physician practice, hospital or managed care, one year of knowledge of managed care including data maintenance of facility and/or profiles, or one year of credentialing experience in a medical office setting is preferred.

Certification/Licensure:

None.

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