Credentialing and Payor Contracting Specialist (Full-Time)

ChildServe

Johnston, Iowa

JOB DETAILS
SKILLS
Accounting, Administrative Skills, Analysis Skills, Autism, Behavioral Health, Communication Skills, Contract Analysis, Contract Management, Contract Negotiation, Contract Processing, Dental Insurance, English Language, Finance, Financial Analysis, Financial Compliance, Financial Planning and Analysis (FP&A), Government Relations, Health Economics, Healthcare, Healthcare Administration, Healthcare Providers, Hospital, Hospital Administration, Internal Audit, Interwoven, Leadership, Legal Support Skills, Managed Care, Medicaid, Medical Billing, Medical Office Administration, Metrics, Organizational Skills, Patient Care, Pediatrics, Physician Credential, Problem Solving Skills, Process Development, Process Improvement, Process Management, Provider Credentialing, Public Accounting, Record Keeping, Regulations, Reimbursement, Reporting Dashboards, Reporting Skills, Retirement Plan, Revenue Analysis, Source Code/Configuration Management (SCM), Support Documentation, Time Management, Vision Plan
LOCATION
Johnston, Iowa
POSTED
13 days ago

Description

This is a newly created role responsible for overseeing end-to-end provider and entity credentialing, payor enrollment, and medical staff privileging to ensure timely and accurate participation with Medicaid, MCOs, and commercial payors. The position also supports payor contracting by coordinating contract processes and assisting with financial and reimbursement analysis in partnership with key internal teams.

 

How You’ll Have an Impact
 

Payor Credentialing & Enrollment

  • Manage end-to-end credentialing and enrollment of organizational entities with Medicaid, MCOs, and commercial payors.
  • Credential and recredential physicians, advanced practice providers (APPs), and other clinical providers with all applicable payors.
  • Maintain credentialing timelines to avoid lapses in participation or reimbursement.
  • Serve as the primary point of contact with payors for credentialing-related inquiries, follow-ups, and issue resolution.
  • Maintain accurate provider and entity data in credentialing systems, CAQH, and internal databases.
     

Hospital Medical Staff Privileging

  • Provide administrative support for hospital medical staff credentialing and privileging processes.
  • Compile, submit, and track required documentation for initial and ongoing privileges.
  • Monitor expiration dates and renewal cycles to ensure continuous compliance with hospital and regulatory requirements.
  • Coordinate communication between providers, hospitals, and internal stakeholders related to privileging status.

 

Payor Contract Financial Analysis Support

  • Assist with the financial review and analysis of payor contracts in coordination with the Director of Revenue Cycle and the VP of Government Relations.
  • Support evaluation of reimbursement methodologies, rate structures, and contract terms.
  • Help prepare summaries, comparisons, and impact analyses to inform contract negotiations and strategic decision-making.
  • Maintain organized records of executed payor agreements and supporting financial documentation.

 

Contract Intake, Review & Dissemination

  • Serve as the central point person for coordinating the intake, tracking, and dissemination of all organizational contracts (payor and non-payor).
  • Manage and enforce the contract checklist process for contracts entering or exiting the organization, ensuring appropriate review and approvals.
  • Coordinate with legal, finance, compliance, operations, and executive leadership to ensure contracts move efficiently through the review process.
  • Maintain a centralized contract repository with accurate status tracking, key dates, and version control.
  • Support contract renewals, amendments, and terminations by monitoring deadlines and notifying stakeholders.
     

Compliance & Reporting

  • Ensure all credentialing, privileging, and contracting activities comply with regulatory, accreditation, and internal policy requirements.
  • Prepare reports and dashboards on credentialing status, contract inventory, expirations, and workflow metrics as requested.
  • Identify process improvement opportunities and recommend efficiencies in credentialing and contract management workflows.



What You’ll Need

  • Bachelor’s degree in Accounting, Finance, Economics, or Healthcare Administration with a strong accounting or financial analysis foundation.
  • 2+ years of experience in a financial analyst, contracting analyst, revenue cycle, or healthcare finance–adjacent role with demonstrable analytical responsibility. Experience in public accounting, internal audit, FP&A, revenue integrity, or healthcare finance.
  • Ability to understand and communicate effectively and professionally in reading, writing, and speaking the English language. 

Benefits

  • Medical, dental, and vision insurance
  • Health Savings Account (HSA) and Flexible Spending Account (FSA) options
  • Employee Assistance Program (EAP)
  • 403(b) retirement plan with company match
  • Life and disability insurance
  • Paid Time Off (PTO)  

Make a Difference Every Day at ChildServe

  • ChildServe partners with families to help children with special healthcare needs live a great life. 
  • ChildServe is a leading pediatric healthcare provider with Iowa’s only children's specialty hospital, offering a variety of services and programs to meet each child’s unique needs.
  • ChildServe’s four key specialty areas include: complex medical care, pediatric rehabilitation, autism and behavioral health, and community-based services. With a coordinated approach to care delivery, services are interwoven and streamlined, so families can address their child’s needs in one location.
  • Established in 1928, ChildServe proudly provides more than 30 pediatric specialty services to nearly 6,000 children in Iowa each year. 

ChildServe is committed to working with and providing reasonable accommodations to applicants with disabilities. To request assistance with the application process, please email [email protected]. ChildServe is an Equal Opportunity Employer. 

 

About the Company

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ChildServe