Credentialing Specialist/ Contract Reviewer

2 weeks ago


Phoenix, United States Southwest Network Full time

Responsible for all aspects of the credentialing, re-credentialing and privileging processes for all medical practitioners providing member care at Southwest Network. Ensures practitioners are credentialed, affiliated and approved with health plans and all appropriate sites. Maintains up-to-date data for each practitioner in credentialing databases and online systems, plus renews licenses and certifications in a timely manner.

All members of our team are expected to provide support and services in accordance with the Nine Guiding Principles for Recovery Oriented Adult Behavioral Health Services and Systems and practice in a manner that is consistently mindful of the 12 Principles of The Arizona Vision for Children.

A complete job description is available upon request.

**REQUIREMENTS**

**Education, Certification, and Experience Requirements**
- High School diploma or equivalency certificate required; associates degree preferred.
- Two (2) years relevant credentialing experience preferred.
- Two (2) years contract reviewing experience preferred.
- Knowledge and understanding of the medical credentialing process, DEA certification, and CAQH and NHSC requirements preferred.
- Knowledge of local, state, and national contract laws.
- Must maintain a valid Arizona state fingerprint clearance card.
- Must be at least 21 years of age.

**Knowledge, Ability, and Skills**
- Requires the ability to research and analyze data and excellent attention to detail.
- Must be ale to establish and maintain effective communication and working relationships with medical practitioners, contractors, management and staff, as well as contracts outside the organization.
- Must possess excellent customer service skills
- Requires strong writing, verbal and interpersonal communication skills.
- Strong organizational skills and the ability to utilize multiple types of office equipment (i.e. phones, copier, fax, etc.)
- Ability to type 25 to 40 WPM is preferred
- Must be able to utilize the internet and various web browsers

**COMPENSATION and BENEFITS**
- This position is offered at a fair, competitive salary.
- Medical, Dental, and Vision insurance
- Health Savings and Flex Spending account options
- Paid sick, vacation and holiday time (10 paid holidays per year)
- Tuition reimbursement
- Retirement plan (403b) with company match
- Disability insurance
- Basic life insurance with the option to purchase supplemental insurance
- Employee Assistance Program
- Employee Discounts

When you consider everything—the salary, the benefits, the ongoing training and support we offer, and the impact you’ll have on the lives of others—it could be the right opportunity for you.

Any offer of employment is contingent upon verification of education, employment, driving record and auto insurance, and completion of a criminal background check and drug testing.

Southwest Network is an equal opportunity employer.

**ABOUT SOUTHWEST NETWORK**

Southwest Network provides integrated behavioral and physical health services, caring for both the mind and body for whole health and wellness. We provide treatment programs for seriously mentally ill adults and children and adolescents with complex emotional and behavioral needs. We are committed to their recovery, and we work together to offer hope, support individual goals, encourage self-sufficiency, and change lives. We do whatever is needed for the individuals and families we serve.

We truly understand how important our employees are to those they care for, and how critical they are to our mission. As one of our employees, we will look after as many of your professional and personal needs as we can and make sure your work environment is productive, yet pleasant and informal. We are committed to offering you opportunities for personal and career growth, and we value and reward innovation, collaboration, dedication, and strength.



  • Phoenix, United States Southwest Network Full time

    Responsible for all aspects of the credentialing, re-credentialing and privileging processes for all medical practitioners providing member care at Southwest Network. Ensures practitioners are credentialed, affiliated and approved with health plans and all appropriate sites. Maintains up-to-date data for each practitioner in credentialing databases and...


  • Phoenix, Arizona, United States NATIVE HEALTH Full time

    Job Description The Credentialing Specialist is responsible for all aspects of the initial credentialing, re-credentialing, and privileging processes for all licensed/certified providers and staff who provide patient care at Native Health. This position maintains up-to-date data for each provider in credentialing databases and online systems and ensures...

  • Contracts Specialist

    2 weeks ago


    Phoenix, United States SA Technologies Inc Full time

    Job Description Title: Contracts Specialist Location: Phoenix, AZ, 85007 Duration: 12 months Client: State of Arizona Requisition ID: 731 Job Description Manages post-award activities for contracts and grants, including intergovernmental and interagency agreements. Ensures Division's strategic goals by contributing to Standard Work development. Authorizes...


  • Phoenix, United States SA Technologies Inc Full time

    Job Description Role: Penalty Review Specialist Estimated Duration: 6+ months Location: Phoenix, AZ (hybrid) Position Description The Penalty Review Specialist plays a vital role in evaluating and analyzing data submitted by customer applicants for penalty abatement consideration. Utilizing problem-solving, critical thinking, and decision-making skills, the...


  • Phoenix, United States Turner & Townsend Group Full time

    Contract Support Specialist - Contract Services Full-time From the inception of a project through to completion and beyond, Turner & Townsend help to deliver the outcomes that matter through transformational programs covering the full spectrum of consultancy, project delivery and post-project operations. With offices located globally, you're never far away...


  • Phoenix, United States SA Technologies Inc Full time

    Job DescriptionTitle: Contracts SpecialistLocation: Phoenix, AZ, 85007Duration: 12 monthsClient: State of ArizonaRequisition ID: 731Job DescriptionManages post-award activities for contracts and grants, including intergovernmental and interagency agreements. Ensures Division's strategic goals by contributing to Standard Work development. Authorizes payments,...

  • Credentialing Advisor

    2 weeks ago


    Phoenix, United States The Cigna Group Full time

    Primary Job Duties and Responsibilities:Manages health plan requests, audits, and delegated credentialing programs to maintain positive relationships between the health plan, physician, providers, and practice managers. Leads credentialing efforts, providing expert guidance on all provider credentialing projects. Supports and provides direction to other...

  • Dir, Corp

    6 days ago


    Phoenix, United States TriWest Healthcare Alliance Full time

    **Profile**: Veterans, Reservists, Guardsmen and military family members are encouraged to apply!! We offer remote work opportunities (AK, AR, AZ, *CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TX, UT, VA/DC, *WA, WI & WY only) **Job Summary** Director will focus on expanding and strengthening our provider network...


  • Phoenix, United States Building People LLCThe Full time

    As a recognized leader in real estate and facilities services, The Building People provides innovative solutions that integrate technology, buildings, and people through strategic thought leadership and expertise. We enhance our customers' ability to build a culture that optimizes performance in the built environment. Our strategy leads clients towards the...


  • Phoenix, United States SA Technologies Inc Full time

    Job Description Role : Contract Management Specialist III Estimated Duration : 6+ months Location: Phoenix, AZ (hybrid) Position Description The Contract Action Unit is dedicated to supporting the Client by ensuring the meticulous adherence to contractual agreements, policies, and compliance standards. In this role, the incumbent will conduct extensive...


  • Phoenix, United States American Dental Companies Full time

    We are a Patient and Team Focused Private Dental Practice looking for a great individual to join our excellent team.We pay at the top end of the profession and provide medical, dental, PTO, paid vacations and additional training and guidance to help our team members reach their career growth and professional goals.We are looking for applicants that have the...


  • Phoenix, United States The Building People Full time

    Job DescriptionJob DescriptionThe Building People has a need for a full-time Lands and Realty Specialist (Realty Technician IV) supporting the Engineering and Construction Division. The employee will provide technical support services and perform the following duties and tasks:Reviews design plans and specifications for conformance with WAPA’s transmission...


  • Phoenix, United States Zobility Full time

    Job Description:Reporting to the Senior Manager – Supply Chain Contracts within the Supply Chain Contracts team, this is a strategic role within the Legal, Contracts and Compliance function.This position coordinates with business partners on allocated supply chain contract matters, manages a complex portfolio of allocated supplier contracts, communicates...


  • Phoenix, Arizona, United States CommonSpirit Health Full time

    Overview: CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...


  • Phoenix, United States People, Data & Solutions Full time

    Test Data QA Contract to hire - remote but must be in AZ The Test Data Specialist - Quality Assurance will be responsible for creating, sourcing, and managing data that will be used through all phases of the Software Development Life Cycle by various testing teams in the organization to support in-scope testing activities. The Test Data Specialist will be...


  • Phoenix, United States Compunnel Inc. Full time

    Role Procurement Specialist. Locations as per business needsTempe, AZ - 85284Phoenix AZ - 85034Hybrid (3 days in the Office, 2 days from Home)Job DescriptionWe are looking for Procurement Specialist. with experience in negotiations, a business mindset to execute to our key KPI’s. The job will be on a team with focus on execution and maintenance of our...


  • Phoenix, United States SA Technologies Inc Full time

    Job Description Role: Accounting Specialist 2 Estimated Duration : 6+ months Location: Phoenix, AZ (hybrid) Position Description Under general supervision, the Accounting Specialist 2 is responsible for entering, reviewing, analyzing, validating, and reconciling provider payments into the Client. This position is also responsible for ensuring the accurate...


  • Phoenix, Arizona, United States findojobs Full time

    The Business Development Specialist is responsible for maintaining strong relationships with customers and commercial management for tolling services. The business development specialist reports to the manufacturing commercial manager with a dotted line to the plant manager.Duties and Responsibilities:Develop strong customer relationships at multiple levels...

  • Compliance Specialist

    2 weeks ago


    Phoenix, United States Motion Recruitment Full time

    Our Client, a Worldwide Financial Services Company, is looking for a Compliance Specialist to join their team in Phoenix, AZHybrid Schedule: 3 days onsite/ 2 days remotePay: $25***This Is A 5 Month Contract Open to Extension Or Conversion!***As the Compliance Specialist, you will work with the Third-party Lifecycle Management Department which is responsible...

  • Compliance Specialist

    2 weeks ago


    Phoenix, United States Motion Recruitment Full time

    Our Client, a Worldwide Financial Services Company, is looking for a Compliance Specialist to join their team in Phoenix, AZHybrid Schedule: 3 days onsite/ 2 days remotePay: $25***This Is A 5 Month Contract Open to Extension Or Conversion!***As the Compliance Specialist, you will work with the Third-party Lifecycle Management Department which is responsible...