Contracting & Credentialing Coordinator

Hillsborough PACE 5414 Beaumont Center Blvd Suite 200 Tampa, FL 33634, USA

Empath Health is seeking a detailed oriented Contracting and Credentialing Coordinator to join our interdisciplinary PACE team in Pinellas County, FL. In this role, the PACE Contracting and Credentialing Coordinator is responsible for managing the overall integrity, compliance and quality of the PACE program(s) vendor networks. The PACE Contracting and Credentialing Coordinator oversees and facilitates the preparation and development of all new provider and vendor contracts, as well as ensures ongoing compliance of current networks.

Flexibility to commute between Pinellas, Hillsborough, Manatee, and Sarasota counties.

The Program of All-Inclusive Care for the Elderly (PACE) is a unique care model designed to help older adults remain independent and safe in their own homes.

• Relationship-Based Care with Real Impact:
  Build lasting connections with participants, supporting their independence and mobility—this is a meaningful alternative to inpatient rehab or traditional outpatient care.
• Team-Driven, Preventive Focus:
  Collaborate with physicians, nurses, social workers, and other clinicians in a true interdisciplinary care model focused on prevention and holistic well-being.

Contracting

• Maintains ongoing understanding and knowledge of PACE federal regulations regarding contracting and credentialing
• Responsible for management of PACE contracts including negotiations of new contracts, re-negotiations of current contracts, as well as monitoring of contract compliance
• Facilitates fiscally responsible contract negotiations
• Works closely with leaders from all PACE centers to ensure contracting needs are addressed timely
• Acts as primary liaison between prospective and current vendors>
• Maintains electronic inventory of active contracts to ensure compliance with all regulatory network adequacy requirements
• Communicates with appropriate PACE Center staff regarding new contracts
• Completes single case agreements as needed
• Periodically meet with potential and active contract and vendor staff as needed
• Provides oversight and training/education to potential contractors on the Vendor Contracting Process to ensure the following is completed accurately and promptly
• Provides communication to potential contracted providers and vendors in the contract process:
• Obtaining all necessary information for a new contract including, but not limited to contact information, new business/provider name, NPI, Tax , W9, insurance, etc.
• Ensuring all necessary vendor information is loaded and maintained into the EMR system
• Assists in resolving any vendor disputes and complaints timely and appropriately
• Other duties as assigned
• Knowledge of healthcare regulatory compliance and quality measures

Credentialing

• Facilitate the completion of required credentialing tasks for all new vendor contracts including verification of appropriate licensing, insurance, OIG checks, etc.
• Provides training/education materials to new vendors
• Monitor expiring vendor credentials and facilitate timely renewals
• Completes annual recredentialing and training process for all active vendors including, but not limited to, validation of appropriate licensure, insurance, and providing PACE education materials
• Managed and facilitates the completion of monthly preclusion list
• Other duties as assigned

• Earn Competitive Pay: Your skills and contributions are recognized and rewarded.
• Benefits & Wellness: Medical, dental, vision, life insurance, retirement with company match, plus wellness programs to support your mind and body.
• Industry-Leading PTO: 5+ weeks to rest, recharge, and live your Full Life.
• Grow Your Career: CEU support, tuition reimbursement, and advancement opportunities.
• Make a Difference: Join a mission-driven team dedicated to kindness, compassion, and Full Life Care for All.

• High School or GED required.
• Bachelor’s degree in business or healthcare administration preferred
• At least 2 years of previous contracting experience required
• Managed Care/Capitated program experience preferred.
• Successfully complete a Competency Assessment upon hire and receive…