As Moving Analytics rapidly expands its partnerships with payors, we are looking for a detail-oriented and passionate team member to manage payor implementations.

As part of this role, you will have the opportunity to work with our legal and health plan network team with the end goal of ensuring our providers are in-network nationally.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Key Responsibilities

  • Complete provider credentialing and re-credentialing applications; monitors applications and follows-up as needed
  • Maintains corporate provider contract files
  • Maintains knowledge of current health plan and agency requirements for credentialing providers
  • Track license and certification expirations for all providers to ensure timely renewals
  • Ensure practice addresses are current with health plans, agencies, and other entities
  • Compile and maintain current and accurate data for all providers
  • Ensure correct providers are linked to practices
  • Enroll new practices and providers into health plan network
  • Complete Monthly State License Monitoring
  • Identify discrepancies in formation and conduct follow-ups, as needed
  • Assist customers with credentialing inquiries
  • Follow-up with providers for expired/ expiring documents
  • Set up and maintain provider applications with health plans to obtain payments for Company’s services
  • Implement processes for credentialing and registration of Company’s providers with Government and Commercial plans
  • Maintain physician rosters with health plans, per the requirements of each health plan
  • Assist in onboarding of Company’s providers including managing and updating CAQH profiles
  • Maintain up-to-date status for tracking towards being an in-network provider for each payor in the Sales pipeline
  • Prepare reports to assist Company’s business operations and to respond to state audits
  • Oversee regulatory compliance expectations for state and federal programs

Minimum Qualifications

  • Bachelor’s Degree or equivalent with a minimum 3 years of credentialing/payor network related work
  • At least 2 years experience in regulatory requirements related to credentialing
  • At least 2 years experience in registering providers with Medicare and Medicaid plans
  • Proficient in Excel and basic data analysis
  • Crisp communication skills
  • Meticulous and detail-oriented with ability to maintain high standard of accuracy