Specialist II, Contract Operations

The Credentialing Specialist is a remote role within DaVita's Payor Partnerships Contract Operations team, responsible for managing credentialing documentation, interpreting contract language, resolving network issues, and maintaining data accuracy for Fee For Service Agreements.

Location: Remote (US)

Salary: $22.50–$28.50/hr

Responsibilities

• Accurate and timely contract reviews regarding language, check lists, codes, rates, and credentialing operational language.
• Research and resolve complex network and claims issues, collaborating with Credentialing Specialists and Negotiation teams.
• Analyze root causes of delays or denials using tools such as the A3 worksheet format.
• Assess complex situations and communicate effectively to leadership using the SBAR format.
• Maintain accurate data across multiple systems (Orion, CLM, COR, Salesforce, IBM-based systems).
• Provide data for weekly reports, including task categories, email volume, out of SLA task assistance, and escalation tracking.
• Maintain an average QA score at or above 95% for critical errors.
• Build and maintain strong relationships with external payor contacts and internal partners.
• Manage a high volume of work, including email inboxes below 40, responding within 1-2 business days, and prioritizing tasks based on risk and value.
• Resolve 90+% of tasks within due date or SLA.
• Handle a volume of approximately 4,500 credentialing packets annually.

Requirements

• High school diploma or equivalent; Associate’s or Bachelor’s degree preferred.
• Minimum 2 years of experience in high-volume research, customer account ownership, or complex administrative resolution work.
• Proven top performance in a production environment.
• Advanced Excel skills (complex formulas, VLOOKUP, mail merge, conditional formatting).
• Proficiency in Microsoft Outlook, Word, PowerPoint, SharePoint; experience with Salesforce or database management preferred.

Benefits

• Comprehensive benefits including medical, dental, vision, 401(k) match, paid time off, PTO cash out.
• Support for family resources, EAP counseling, Headspace®, backup child and elder care, maternity/paternity leave.
• Professional development programs, virtual leadership and development courses.

Additional Information

• Position is 100% remote within the continental US.
• Wage range is $22.50–$28.50 per hour, with specific salaries based on location and exemption status.
• The role is open for at least three days.
• DaVita is an equal opportunity employer.