Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.
As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together. This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin.
JOB SUMMARY/PURPOSE The Provider Contract & Credentialing Coordinator is responsible for supporting the administration, tracking, and maintenance of provider contracts and related documentation. The position coordinates contract workflow activities, ensures accurate system configuration, and assists with oversight and communication with delegated entities related to credentialing requirements. Serves as a key liaison between Contracting, Credentialing, Compliance, and delegated provider groups to ensure contractual, credentialing oversight, and regulatory obligations are met.
Acts as the credentialing auditor for delegated provider groups. EXPERIENCE/EDUCATION/QUALIFICATIONS High school diploma or equivalent required. Three (3) years of experience in healthcare contracting, provider network operations, credentialing, or related managed care functions required.
Experience supporting provider contract administration and/or credentialing processes required. Experience working with contract management systems, provider databases, or workflow tracking tools required. Experience working with delegated credentialing models within Medicaid, Medicare Advantage, or Commercial health plans preferred.
KNOWLEDGE/SKILLS/ABILITIES Knowledge of provider contracting lifecycle and documentation requirements. Understanding of credentialing standards (e.g., CMS, state Medicaid, NCQA, or URAC requirements). Strong organizational skills and attention to detail.
Analytical skills to review documentation for completeness and compliance. Ability to manage multiple projects and deadlines simultaneously. Effective written and verbal communication skills.
Ability to collaborate cross-functionally with Contracting, Credentialing, Compliance, and delegated provider entities. Proficiency in Microsoft Office and contract tracking systems. PHYSICAL DEMANDS Rarely (1 - 10% of the time) Occasionally (11 - 33% of the time) Frequently (34 - 66% of the time) Continually (67 – 100% of the time) CLIMB - STAIRS LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs LIFT (Knee to chest: 24"-54") 0 – 20 Lbs LIFT (Waist to Eye: up to 54") 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds BEND FORWARD at waist KNEEL (on knees) STAND WALK – LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0 - 20 pounds force) PULL (0 - 20 pounds force) SIT CARRY 2-handed, 0 - 20 pounds ROTATE TRUNK Sitting REACH - Forward MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist