Credentialing Specialist, Managed Care- Northampton at Partner's Healthcare in Northampton, Massachusetts

Job Description:

Site: Mass General Brigham Medical Group Western Massachusetts, Inc.


At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission-from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.


At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare - people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds - to apply.


Join a Team Dedicated to Excellence in Healthcare!


Are you an organized and detail-oriented professional looking to make an impact in healthcare administration? Cooley Dickinson Physician Hospital Organization (CDPHO) is seeking a Managed Care Credentialing Specialist to play a key role in ensuring seamless provider enrollment and credentialing. This hybrid position offers the flexibility of working remotely while staying connected with a collaborative team in Northampton, MA.


Why Join Us?
✅ Hybrid Schedule - Work on-site 3 days per week for the first 90 days, then transition to 1 day per week on-site with the rest remote.


✅ Meaningful Work - Ensure providers can focus on delivering high-quality care by managing credentialing and enrollment with efficiency.


✅ Supportive Team - Work alongside experienced professionals in a mission-driven healthcare organization.


✅ Career Growth - Gain exposure to more advanced tasks and develop expertise in managed care, provider relations, and healthcare operations.


This is an excellent opportunity for someone passionate about healthcare administration who enjoys working both independently and as part of a team.



Job Summary
What You'll Do:


• Streamline Provider Enrollment - Submit, track, and manage applications for credentialing and participation with contracted health plans.


• Maintain Membership Documents - Keep accurate records of provider enrollment, credentials, and membership status.


• Facilitate Communication - Act as a key point of contact for providers, assisting with onboarding and resolving managed care-related issues.


• Advocate for Providers - Research health plan policies and assist in resolving enrollment and payment challenges.


• Ensure Compliance - Track required hospital privileges, obtain necessary contract signatures, and keep credentialing records up to date.



Qualifications


✔ Experience: At least 3 years of medical office experience or medical administrative experience with knowledge of HMO and PPO insurance.
✔ Education: High school diploma required; Associate's degree in business, finance, or healthcare administration preferred.
✔ Technical Skills: Microsoft Excel experience and ability to work with databases.



Additional Job Details (if applicable)


✔ Attention to Detail: Ability to manage multiple tasks with accuracy and efficiency.
✔ Strong Communication: Ability to interact professionally with healthcare providers, insurance companies, and internal teams.



Remote Type


Hybrid



Work Location


30 Locust Street



Scheduled Weekly Hours


40



Employee Type


Regular



Work Shift


Day (United States of America)



EEO Statement:


Mass General Brigham Medical Group Western Massachusetts, Inc. is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.



Mass General Brigham Competency Framework


At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.