Credentialing and Contract Manager

Description

Join Our Team as a Contract & Credentialing Manager at Best Care!
Are you passionate about ensuring compliance and building efficient systems that support quality care? Best Care is seeking a Contract & Credentialing Manager to oversee the full lifecycle of contract management, provider and facility credentialing, and third-party payer enrollment. In this pivotal role, you’ll collaborate across departments—including Finance, Operations, HR, and Leadership—to maintain a compliant infrastructure that supports revenue optimization and audit readiness.

As the primary point of contact for funders, credentialing entities, and insurance plans, you’ll help ensure accurate documentation and consistent revenue flow while advancing our mission:
to advocate and provide compassionate care in the treatment and prevention of addictions and mental illness
.

The Contract & Credentialing Manager oversees the organization’s full lifecycle of contract management, provider & facility credentialing, and third-party payer enrollment processes. This role ensures compliance with federal, state, payer, and accreditation requirements while supporting revenue optimization through accurate and timely provider enrollment and maintenance with all contracted insurers. Working cross-functionally with Finance, Operations, Human Resources, Leadership, and external partners, this position ensures Best Care maintains a compliant, efficient infrastructure for contracts, grants, credentialing, and payer enrollment.

The role serves as the primary point of contact for funders, credentialing entities, and insurance or third-party payer plans, ensuring accurate documentation, audit readiness, and consistent revenue flow through maintaining active provider participation status.

• Manages a diverse portfolio of federal, state, local, and private contracts and grants, ensuring compliance with award terms, deliverables, reporting deadlines, and regulatory requirements;
• Coordinates contract review, negotiation, renewal, and execution processes across all departments and sites;
• Ensures any and all credentialing and enrollment requirements of contracts are accurate, timely, and aligned with each respective contract;
• Ensures contract language aligns with HIPAA, Medicaid, 42 CFR, and healthcare compliance standards;
• Maintains centralized repositories for contracts, grants, amendments, reporting, and historical documentation;
• Serves as primary liaison to funders and subcontractors for contract terms, compliance expectations, and reporting requirements;
• Leads internal contract audits, monitors risk, and ensures audit-ready documentation;
• Supports multi-year funding projections, renewal strategies, and alignment with organizational growth priorities.

• Ensures complete and accurate initial and re-credentialing of all licensed providers, volunteers, contractors, and temporary clinical staff;
• Ensures credentialing processes comply with internal policy, payer requirements, and regulatory standards;
• Coordinates collection, primary source verification, and maintenance of licensure, DEA, malpractice coverage, certifications, education, and references;
• Maintains credentialing files and documentation in EHR and dedicated credentialing software and ensures data accuracy, auditing, reporting, and system maintenance;
• Provides high-level process support to ensure timely completion of credentialing requirements and expiring documents.

• Initiates, manages, and maintains enrollments for all providers with Medicaid, Medicare, and other third-party and commercial payers;
• Ensures accurate provider status, directory listings, site locations, and effective dates to prevent revenue disruption;
• Partners with payer representatives and internal billing teams to resolve barriers to enrollment, claim denials, or contract discrepancies;
• Supports development and coordination of provider employment agreements as they relate to enrollment or credentialing requirements.

• Tracks and audits credentialing, contracting, and…