Credentialing & Contract Manager

The Credentialing & Contract Manager is responsible for managing the end-to-end credentialing life cycle for healthcare providers and supporting payer contracting activities that strengthen organizational performance. This dual-function role ensures full compliance with regulatory requirements, verifies provider qualifications, and assists with payer contract maintenance, analysis, and coordination. The position plays a critical role in safeguarding the integrity of our healthcare operations while supporting contractual alignment across our payer networks, hospitals, and affiliated entities.

Essential Functions of the Role  :

Credentialing Responsibilities

• Collect, verify, and maintain documentation for the credentialing and recredentialing of healthcare providers.
• Conduct background checks and review professional references.
• Ensure timely and accurate completion of credentialing applications, including CAQH, state Medicaid programs, Medicare PECOS, hospital medical staff offices, and commercial payer portals.
• Maintain up-to-date knowledge of state, federal, and accreditation requirements (e.g., CMS, NCQA, Joint Commission).
• Ensure compliance with organizational policies and credentialing standards.
• Maintain and update provider credentialing databases and tracking tools.
• Generate reports and track the status of credentialing and privileging applications with hospitals and health plans.
• Serve as a point of contact for healthcare providers regarding credentialing requirements, timelines, and status updates.
• Collaborate with clinical, administrative, and onboarding teams to facilitate seamless provider integration.
• Identify opportunities to optimize workflow in credentialing processes.
• Participate in training and development activities related to credentialing best practices.

Responsibilities

Minimum Qualifications

Desired Qualifications

Work Environment :   This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, scanners, filing cabinets and fax machines.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to see, talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. This position requires the ability occasionally to lift files, office products and supplies, up to 20 pounds.  This position is primarily a desk position, requiring sitting longer hours at the computer typing on a keyboard.

Days / Hours :   This is a full-time position, the schedule of which is determined by the Supervisor. Can work varying or longer schedules, if needs require.

Travel :   Travel will be required to affiliated physician practices (~2x / month) and quarterly off-sites.  HVP’s executive team is headquartered in suburban Chicago and attendance at company-wide is expected at least once per quarter for management meetings is anticipated.

Other Duties :   As assigned .

Compensation details : 65000-85000 Yearly Salary

PI063e6626bb13-30511-39084218