What are the responsibilities and job description for the Credentialing Specialist position at Cascadia Healthcare?
About Us
Cascadia Healthcare is a leading provider in the skilled nursing industry, driven by a shared commitment to service and doing good for others. With operations across Idaho, Washington, Oregon, Montana, and Arizona, our mission is to be a Force for Good, for our residents, our employees, and the communities we serve.
As our organization continues to grow, we are seeking a Credentialing Specialist to join our Home Office team in Eagle, Idaho. Reporting directly to the Director of Managed Care, this role will take ownership of credentialing and recredentialing activities across our Skilled Nursing Facilities (SNFs) and Assisted Living Facilities (ALFs), while also supporting managed care contract administration and payer enrollment activities.
This is an excellent opportunity for a healthcare credentialing professional who is looking to expand their expertise and gain exposure to managed care contracting, payer relations, and healthcare operations.
About the Role
The Credentialing Specialist will play a critical role in ensuring our facilities maintain active participation with Medicare, Medicaid, Managed Care, Commercial, and Government payers. This position is responsible for coordinating credentialing and recredentialing processes, managing payer enrollment requirements, supporting non-negotiable government agreements, and assisting with contract administration activities.
The ideal candidate is highly organized, detail-oriented, and able to work independently while collaborating with leaders throughout the organization.
What You’ll Do
Credentialing & Compliance
- Manage credentialing and recredentialing activities for Skilled Nursing Facilities (SNFs) and Assisted Living Facilities (ALFs).
- Prepare, submit, track, and maintain credentialing applications and related documentation.
- Monitor renewal timelines and ensure all credentialing requirements are completed accurately and on time.
- Develop and maintain systems and processes to track credentialing status, expirations, and payer enrollment requirements.
- Serve as a liaison with Medicare, Medicaid, Managed Care, Commercial, and Government payers regarding credentialing matters.
- Support future credentialing process improvements and automation initiatives.
- Ensure compliance with all applicable federal, state, payer, and company requirements.
- Adhere to Cascadia Healthcare's Code of Conduct, policies, and procedures.
- Maintain compliance with standards established by CMS, state regulatory agencies, and contracted health plans.
Managed Care Contract Support
- Support Managed Medicaid agreements for Olympus Retirement Living communities.
- Manage non-negotiable government agreements, including VA, TriWest, Tricare for Life, and other government payer programs.
- Assist with contract administration, implementation, tracking, and maintenance.
- Support annual contract reviews and help identify agreements approaching renewal.
- Maintain contract records and ensure documentation is current and accessible.
- Assist with national and local payer agreements as assigned.
Collaboration & Communication
- Support the implementation and ongoing management of Managed Care Master and related reporting tools.
- Assist in collecting and organizing data for managed care reporting and operational analysis.
- Build and maintain positive relationships with health plans, government agencies, and payer representatives.
- Collaborate with facility leadership, Operations, Legal, Revenue Cycle, and Home Office teams to communicate contract updates and payer requirements.
- Support training and education efforts related to credentialing and payer participation processes.
What You Bring
- 3 years of experience in healthcare credentialing, provider enrollment, managed care administration, healthcare operations, or a related field.
- Strong organizational skills and exceptional attention to detail.
- Ability to manage multiple projects, deadlines, and priorities independently.
- Excellent written and verbal communication skills.
- Strong problem-solving abilities and professional judgment.
- Proficiency with Microsoft Office applications, including Excel.
Preferred Qualifications
- Experience in Skilled Nursing, Long-Term Care, Post-Acute Care, Assisted Living, or healthcare services.
- Experience managing credentialing or payer enrollment requirements with Medicare, Medicaid, Medicare Advantage, Managed Medicaid, Commercial, and Government payers.
- Familiarity with managed care contract administration and payer relations.
- Knowledge of healthcare reimbursement models, including SNF reimbursement, per diem arrangements, and value-based care programs.
- Experience working with contract management or credentialing software systems.
Why Join Us
- Salary Range: $70,000 – $80,000 DOE
- Medical, dental, and vision benefits
- Paid time off, vacation and sick leave
- Life insurance
- Short-term and long-term disability coverage
- Employee Assistance Program (EAP)
- Professional Development Opportunities
- Career Growth Potential
- Collaborative and Mission-Driven Culture
- Opportunity to make a meaningful impact across a growing healthcare organization
Ready to Make an Impact?
If you're a motivated healthcare professional with credentialing experience and a desire to grow your expertise in managed care and payer relations, we'd love to hear from you.
Apply today and join Cascadia Healthcare as a Force for Good.
Salary : $70,000 - $80,000