Position Purpose:

 As a Managed Care Contract & Enrollment Specialist, you will play a crucial role in ensuring the accuracy and integrity of provider data within the organization. This position will be responsible for managing provider enrollments, credentialing, and contract information, as well as providing support for billing and IT-related tasks. The position will support the senior consultant in implementing, operationalizing, and administering managed care agreements.

What You Will Do:

Coordinate and complete CMS and State enrollments for each agency (27 NPI’s) and clinical providers.

Process commercial credentialing and recredentialing requests

Ensure compliance with all applicable regulations and standards

Create and maintain an issue tracker to document and track billing problems.

Coordinate Payor EFT forms and ensure timely processing.

Supports and participates in joint operating committee meetings with Health Plan leadership to assess and address issues impacting the business relationship between the Plan and RHM

Benefits:

Day 1 Benefits - Health, dental and vision insurance

Employee Referral Reward Program

Short and long-term disability

403b

Generous paid time off

Comprehensive orientation

Minimum Qualifications:

Bachelor's degree in healthcare administration, business administration, or related field.

Minimum of 2 years of experience in provider data management, healthcare administration, or a related

field.

Strong knowledge of CMS and State enrollment requirements.

Experience with commercial credentialing and recredentialing processes.

Must possess analytical, quantitative, evaluative, and critical thinking skills.

Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).

Excellent organizational and time management skills.

Attention to detail and accuracy.

Effective communication and interpersonal skills.

Ability to work independently and as part of a team. Experience with electronic health record (EHR)

systems, such as EPIC.

Knowledge of contract management systems

Apply Today!!!

Our Commitment to Diversity and Inclusion
 

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.