Provider Credentialing Contracting

JOB REQUIREMENTS: Group Health Cooperative of South Central Wisconsin.BETTER TOGETHER Full-time- 40 hours Hybrid role - In-office trainingfollowed by a mix of work-from-home days and office days. Candidate mustlive in the Madison, WI area and be able to work on-site as needed. TheProvider Credentialing & Contracting Coordinator is responsible forsupporting provider contracting, credentialing, and administrativefunctions at Group Health Cooperative of South Central Wisconsin. Theprimary focus of this role is assisting in negotiating and maintainingprovider contracts, serving as the main contact for provider inquiries,overseeing contract setup and auditing, analyzing contracts forpotential renegotiation and training providers in the use ofself-service tools for insurance administration activities. In additionto contracting responsibilities, the specialist assists with thecredentialing and recredentialing processes and ensures compliance withNCQA standards for Delegated Credentialing Agreements. The ProviderContracting and Credentialing Specialist will work under the guidance ofthe Chief Strategy and Business Development Officer. JOB SPECIFICMINIMUM QUALIFICATIONS Associate's or Bachelor's degree in business,healthcare administration or a related field or an applicablecombination of education and work experience required. Bachelor'sDegree preferred. Must be able to understand contract language andprovider payment methodologies. Credentialing certificate preferred butnot required. As a condition of employment, incumbent may be required toobtain certification within a reasonable time period. Knowledge of orability to learn National Committee for Quality Assurance (NCQA) and/orJoint Commission on Health Care Organizations (JCHCO) standardsrequired. Knowledge of and familiarity with medical terminologypreferred. Strong interpersonal and communications skills and theability to work effectively with a wide range of constituencies in adiverse community required. Ability to be culturally sensitive and towork with diverse populations. Strong customer service skills and theability to maintain an excellent rapport with providers and their staffTime management skills and flexibility to work on multipleprojects/assignments simultaneously, with ability to change focus asbusiness needs dictate. Willingness to assume diverse duties andchallenges Knowledge of and proven proficiency in the use of MicrosoftOffice applications including Word, Outlook, Excel and PowerPoint isrequired. Knowledge of and/or ability to learn and use computer basedapplications/software such as electronic time and attendance systems.Ability to use... For full info follow application link. Group HealthCooperative is an Equal Opportunity Employer and all qualifiedapplicants will receive consideration for employment without regard torace, color, religion, sex, sexual orientation, gender identity,national origin, veteran status or disability. APPLICATIONINSTRUCTIONS: Apply Online: ipc.us/t/22B7A66242124760

Created: 2025-12-22