Credentialing and Contract Manager

BestCare Treatment Services Inc•Redmond, OR

About The Position

Join Our Team as a Contract & Credentialing Manager at BestCare! Are you passionate about ensuring compliance and building efficient systems that support quality care? BestCare is seeking a Contract & Credentialing Manager to oversee the full lifecycle of contract management, provider and facility credentialing, and third-party payer enrollment. In this pivotal role, you’ll collaborate across departments—including Finance, Operations, HR, and Leadership—to maintain a compliant infrastructure that supports revenue optimization and audit readiness. As the primary point of contact for funders, credentialing entities, and insurance plans, you’ll help ensure accurate documentation and consistent revenue flow while advancing our mission: to advocate and provide compassionate care in the treatment and prevention of addictions and mental illness. JOB SUMMARY: The Contract & Credentialing Manager oversees the organization’s full lifecycle of contract management, provider & facility credentialing, and third-party payer enrollment processes. This role ensures compliance with federal, state, payer, and accreditation requirements while supporting revenue optimization through accurate and timely provider enrollment and maintenance with all contracted insurers. Working cross-functionally with Finance, Operations, Human Resources, Leadership, and external partners, this position ensures BestCare maintains a compliant, efficient infrastructure for contracts, grants, credentialing, and payer enrollment. The role serves as the primary point of contact for funders, credentialing entities, and insurance or third-party payer plans, ensuring accurate documentation, audit readiness, and consistent revenue flow through maintaining active provider participation status.

Requirements

Proficiency and experience with credentialing and enrollment software systems such as MD Staff, CAQH ProView, Availity, OneHealthPort, and other payer portals used for enrollment, revalidation, and directory maintenance.
High proficiency in MS Office 365 (Word, Excel, Outlook), databases, virtual meeting platforms, internet, and ability to learn new or updated software
Strong interpersonal and customer service skills
Strong communication skills (oral and written)
Strong organizational skills and attention to detail, accuracy, and follow-through
Excellent time management skills with a proven ability to meet deadlines
Critical thinking skills
Ability to maintain strict confidence as required by HIPAA, 42 CFR, and Oregon Statutes
Ability to build and maintain positive relationships
Ability to function well and use good judgment in a high-paced and at times stressful environment
Ability to manage conflict resolution and anger/fear/hostility/violence of others appropriately and effectively
Ability to work effectively and respectfully in a diverse, multi-cultural environment
Ability to work independently as well as participate as a positive, collaborative team member.
Bachelor’s degree in business, Healthcare Administration, Public Administration, or related field preferred
Minimum 3–5 years of experience in credentialing, provider enrollment, contract management, grants administration, or related areas
Equivalent combinations of education and experience may be considered
Must maintain a valid Oregon Driver License or ability to obtain one upon hire, and be insurable under the organization’s auto liability coverage policy (minimum 21 years of age and with no Type A violations in the past 3 years, or three (3) or more Type B violations) and must have a reliable vehicle with adequate insurance to travel as needed

Nice To Haves

Certified Provider Credentialing Specialist (CPCS) desirable
Professional certification or training in grants/contract management (e.g., GPC, CGMS) preferred

Responsibilities

Manages a diverse portfolio of federal, state, local, and private contracts and grants, ensuring compliance with award terms, deliverables, reporting deadlines, and regulatory requirements
Coordinates contract review, negotiation, renewal, and execution processes across all departments and sites
Ensures any and all credentialing and enrollment requirements of contracts are accurate, timely, and aligned with each respective contract
Ensures contract language aligns with HIPAA, Medicaid, 42 CFR, and healthcare compliance standards
Maintains centralized repositories for contracts, grants, amendments, reporting, and historical documentation
Serves as primary liaison to funders and subcontractors for contract terms, compliance expectations, and reporting requirements
Leads internal contract audits, monitors risk, and ensures audit-ready documentation
Supports multi-year funding projections, renewal strategies, and alignment with organizational growth priorities.
Ensures complete and accurate initial and re-credentialing of all licensed providers, volunteers, contractors, and temporary clinical staff
Ensures credentialing processes comply with internal policy, payer requirements, and regulatory standards
Coordinates collection, primary source verification, and maintenance of licensure, DEA, malpractice coverage, certifications, education, and references
Maintains credentialing files and documentation in EHR and dedicated credentialing software and ensures data accuracy, auditing, reporting, and system maintenance
Provides high-level process support to ensure timely completion of credentialing requirements and expiring documents.
Initiates, manages, and maintains enrollments for all providers with Medicaid, Medicare, and other third-party and commercial payers
Ensures accurate provider status, directory listings, site locations, and effective dates to prevent revenue disruption
Partners with payer representatives and internal billing teams to resolve barriers to enrollment, claim denials, or contract discrepancies
Supports development and coordination of provider employment agreements as they relate to enrollment or credentialing requirements.
Tracks and audits credentialing, contracting, and compliance requirements across all sites
Conducts Office of Inspector General (OIG) monthly exclusions review for all staff
Partners with HR to track CME completion, license renewals, and credential expirations
Ensures all credentialing, contracting, and grant documentation meets internal, payer, and regulatory standards
Prepares compliance and performance reports for executive leadership
Supports organizational audits, corrective action plans, and continuous improvement initiatives.
Works closely with HR, Operations, Finance, Clinical Leadership, and Onboarding teams to coordinate and ensure provider readiness
Trains staff on credentialing, enrollment workflows, contract compliance requirements, and documentation standards
Communicates process updates, timelines, and requirements to providers and supervisors
Provides dotted-line mentorship or support to staff engaged in grants, data management, or compliance functions.
Develops and maintains tracking systems, dashboards, and templates for credentialing, contracting, and compliance monitoring
Produces internal communications, summary reports, and process documents to support organizational awareness and compliance
Coordinates agendas, meeting logistics, and documentation as needed for contract or credentialing committees.
Other related duties as assigned
Models BestCare’s mission, vision, and values, promoting integrity, compassion, and collaboration
Supports the organization’s commitment to equity and inclusion, fostering an environment of cultural awareness and respect for all individuals
Aligns department goals with organizational strategic initiatives
Complies with Code of Conduct, Business Ethics, Employee Handbook, and all relevant policies and OARs
Maintains professionalism, confidentiality, and compliance with HIPAA, 42 CFR, and Oregon statutes
Attends required meetings, completes required trainings, and ensures certifications and licenses remain current
Works independently and collaboratively as a positive member of the BestCare team
Performs other organizational duties as assigned