Managed Care contracting/credentialing specialist

Company Description Cascadia Healthcare was founded by partners in skilled nursing and real estate development with a shared commitment to delivering high-quality care to patients and families in the communities they serve. The organization focuses on creating a motivating work environment grounded in quality, empowerment, and accountability. Team members are encouraged to take ownership of their work and contribute to strong, collaborative partnerships. Cascadia Healthcare values honesty, hard work, and consistent delivery of compassionate, patient-centered care. The company strives to support both caregivers and patients through responsible growth and thoughtful leadership.

Role Description The Managed Care Contracting/Credentialing Specialist is a full-time remote role responsible for supporting Cascadia Healthcare’s participation in managed care networks and payer programs. This position oversees contracting activities with managed care organizations, including reviewing, negotiating, and maintaining agreements to align with organizational goals and reimbursement structures. The specialist manages credentialing processes for facilities and providers, ensuring timely enrollment, re-credentialing, and compliance with payer requirements. Daily responsibilities include analyzing contract terms and fee schedules, monitoring Medicaid managed care updates, maintaining accurate provider data, and coordinating with internal stakeholders and external payers. The role also involves responding to inquiries, tracking key deadlines, and preparing reports to support operational and financial performance.

Qualifications

• Candidates should possess strong analytical skills to review contracts, interpret reimbursement terms, and identify financial and operational impacts.
• Candidates should possess contract negotiation skills, including experience working with managed care organizations, payers, or provider networks.
• Candidates should possess Medicaid managed care knowledge, including familiarity with state-specific policies, enrollment processes, and regulatory requirements.
• Candidates should possess effective communication skills to collaborate with internal teams, interface with payers, and clearly document and explain contract and credentialing details.
• Candidates should possess credentialing experience, including managing provider/facility enrollment, re-validation, and maintaining accurate data in credentialing or enrollment systems.
• Relevant qualifications include experience in healthcare administration, managed care, or revenue cycle; proficiency with MS Office and data management tools; and strong organizational and time-management abilities.
• A bachelor’s degree in healthcare administration, business, or a related field, or equivalent combination of education and experience, is preferred; familiarity with long-term care or skilled nursing settings is beneficial.