Privia Health is looking for a Sr. Managed Care Coordination Specialist to play a vital role in our Credentialing and Provider Enrollment Department. You will be responsible for the timely and accurate preparation and submission of provider rosters to contracted health plans to ensure all providers are appropriately paneled and able to bill for services.

What You'll Do

Lead the preparation and submission of comprehensive provider rosters to Managed Medicare, Medicaid, and commercial payers.
Audit internal provider data against database records to ensure 100% accuracy before submission.
Manage all payer portal uploads and secure email submissions, maintaining a detailed log of submission dates and confirmation IDs.
Serve as the primary point of contact for health plans to resolve roster discrepancies, rejections, or paneling delays.
Maintain roster formats in accordance with individual payer requirements and regulatory standards.
Utilize internal databases to provide weekly status reports and analyze provider enrollment timelines for process improvement.
Partner with Revenue Cycle Management (RCM) to identify, troubleshoot, and resolve provider load issues causing claim denials or billing gaps.
Other duties, as assigned.

What We're Looking For

5+ years in healthcare credentialing, provider enrollment, or managed care analysis.
Advanced Excel proficiency required. Candidates must be able to perform VLOOKUPs, pivot tables, and data cleaning for large datasets.
Deep understanding of CAQH, NPI, Availity and the provider enrollment lifecycle required.

Nice to Have

Familiarity with credentialing databases for data management, reporting, and tracking. Experience in CredentialStream preferred.
Experience in Salesforce case management system preferred.
CPMSM, CPCS, or CPES certification through NAMSS preferred.