Contract and Credentialing Administrator

Infucare Rx Inc on behalf of itself and its subsidiaries

About The Position

InfuCare Rx is a leading home infusion provider accredited by URAC and ACHC offering a specialized approach to caring for patients in need of IV therapy and specialty pharmacy services in the homecare setting. We have created an ethical, team oriented, and quality work environment for our employees that cultivates achievement and success. Job Summary: The Contract and Credentialing Administrator will facilitate all phases, contract, initiation/renewal paperwork to include maintenance of documentation and tracking of same. The successful candidate will be detail oriented in monitoring required communication, collateral materials and interaction to ensure licensing, legal and regulatory requirements are in compliance. Effective/timely/detailed interaction with local, state, and national oversight bodies as well as managed care payors and other stakeholders is essential for success. The successful candidate will perform all duties in accordance with company policy/procedure, state professional standards, and other applicable regulatory requirements.

Requirements

Bachelor’s degree required, equivalent education/experience may be considered.
Minimum (3) years’ experience in payor relations or equivalent experience relevant to position as determined by manager.
Experience in credentialing, contract review or other relevant experience with Payor credentialing and recredentialing
Experience and proficient with Microsoft Suites (Outlook, Excel, Word, PowerPoint).

Nice To Haves

Experience working in the acute or specialty infusion pharmacy industry a plus.
Experience working for a national or regional payor or managed care entity.

Responsibilities

Demonstrated ability to adapt to changing priorities and maintain focus under pressure, while consistently meeting deadlines
Organize and mobilize all sensitive information from diverse internal/external sources
Organize and maintain a contracting database
Work with the Regional Directors of Managed Care (RDMC) to efficiently complete credentialing and re-credentialing payor requirements
Work with the National Director of Contracts & Strategy to keep all Medicare and Medicaid enrollments up to date
Establish and maintain an efficient document control system, including organizing, categorizing, and indexing both physical and electronic documents
Work with the RDMC’s to review all contract language; providing contract guidance and support
Track record of meeting goals, defined objectives, business needs and deadlines on a consistent basis
Monitor reportable actions and effectively communicate necessary information in proper format to regulatory bodies, states, payors, or other entities as necessary
Actively support organizational & departmental policies & procedures
Handle company information with appropriate sensitivity & safeguards to ensure confidentiality & right to privacy, in compliance w/HIPAA regulatory requirements
Contribute to the effectiveness of the team by working together by supporting, promoting & applying the best practice standards of conduct including those on attendance, mutual respect & support, honoring diversity, effective communication, & improving the work environment
Exhibit flexibility when work assignments need to be adjusted to meet service, delivery, and workload needs of team
Takes initiative to identify, develop & adapt new policies and practices that improve quality of work
Understand and comply with Healthcare regulatory environment and HIPAA Laws
Other duties as assigned by management.