Managed Care Credentialing Resource

We are building a World Class Service Center and invite you to join a team of people who are committed to a core objective of supporting life changing service and providing professional expertise to the operations and leaders we support.

About the Company

Pennant Services is one of the most dynamic and progressive companies in the rapidly expanding senior living, home health, hospice, and home care industries. Affiliates of Pennant Services now operate 111 senior living, home health, hospice and home care operations across 14 states and we are growing! These operations have no corporate headquarters or traditional management hierarchy. Instead, they operate independently with support from the “Service Center,” a world-class service team that provides the centralized clinical, legal, risk management, HR, training, accounting, IT and other resources necessary to allow on-site leaders and caregivers to focus squarely on day-to-day care and business issues in their individual agencies.

Something else that sets us apart from other companies is the quality of our most valuable resources – our people! We are dedicated to living out our culture as defined by our core values, “CAPLICO” :

C ustomer Second

A ccountability

P assion for Learning

L ove One Another

I ntelligent Risk Taking

C elebrate

O wnership

By incorporating these principles at all levels of our organization, our employees feel valued and excited about their impact on our service center team members and operational partners. Our culture fosters excellence both personally and professionally and promotes development that leads to continued success.

About the Opportunity

Acts as the liaison between our Agencies / Facilities and our managed care plan partners. Participates in strategic decisions and efforts as it pertains to new contracting opportunities, maintains tools and processes to support the completion of timely, compliant and accurate managed care provider applications. Qualified candidate will have a minimum of three years of experience in credentialing. The Managed Care Credentialing Specialist will play a vital role in ensuring that our organization maintains compliance with all credentialing requirements set forth by managed care organizations. This individual will be responsible for managing the credentialing process for Pennant Home Health, Hospice, Personal Care Agencies and Senior Living Facilities within our organization, ensuring that they meet the necessary qualifications and standards to participate in various managed care networks. The ideal candidate will have a strong understanding of credentialing procedures, excellent organizational skills, and the ability to collaborate effectively with internal and external stakeholders.

Duties and Responsibilities

This fulltime position reports to the Director of Managed Care and is responsible for all aspects of credentialing and contracting for the identified Agencies across the organization. Coordinates and supports the completion of timely and compliant managed care provider applications and managed care contracts. Acts as the liaison between our entities and our managed care plan partners.

• Works independently to ensure full compliance with all applicable policies, procedures, bylaws, rules and regulations, accreditation standards and regulations for the processing of applications for initial credentialing and re-credentialing.
• Communicate with managed care organizations to obtain and verify credentialing requirements, submission guidelines, and status updates.
• Ensure that all credentialing applications are completed accurately and submitted in a timely manner to meet managed care organization deadlines
• Coordinates with our Legal, Licensing, Accounts Receivable and Payor Admin to verify and obtain pertinent information.
• Maintain a comprehensive database of Agency / Community credentialing documents.
• Expected to represent our Agencies / Communities and company professionally to all managed care plans and external partners.
• Assist Managed Care Resources and team with special contracting projects as assigned.
• Coordinates with Managed Care Resource to file and maintain contract database.
• Manage the assigned credentialing email inbox.
• Serve as a liaison between our Agencies / Communities and managed care organizations regarding credentialing matters, responding to inquiries and providing necessary information as needed.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Qualifications

Desired Qualifications :

Additional Information

We are committed to providing a competitive Total Rewards Package that meets our employee’s needs.

From a choice of medical, dental and vision plans to retirement savings opportunities through a 401(k), company match and various other features, we offer a comprehensive benefits package. We believe in great work and we celebrate our employees' efforts and accomplishments both locally and companywide, recognizing people daily through our Moments of Truth Program. In addition to recognition we believe in supporting our employees' professional growth and development. We provide employees a wide range of free e-courses through our Learning Management System as well as training sessions and seminars.

Compensation : Based on experience. $50k - $58k

Type : Full Time

Location :

Pennant Service Center

1675 E. Riverside Drive, #150

Eagle, ID 83616

If interested in this position, please submit a resume for consideration. We look forward to hearing from you!

About The Pennant Group