Contracts & Credentialing Manager

Contracts & Credentialing Manager | Atos Medical-US | New Berlin, WI | Remote

Join a growing company with a strong purpose!

Do you want to make a difference for people breathing, speaking and living with a neck stoma? At Atos Medical, our people are the strength and key to our on-going success. We create the best customer experience and thereby successful business through our 1300 skilled and engaged employees worldwide.

About Atos Medical

Atos Medical is a global leader in neck stoma care—dedicated to improving the lives of people living with laryngectomy and tracheostomy. With origins in Sweden and Germany, both our Laryngectomy and Tracheostomy brands bring decades of expertise and innovation in voice and respiratory care, offering trusted solutions such as the Provox® voice prosthesis and TRACOE tracheostomy products.

As part of the Coloplast Group, we operate in over 90 countries with a shared commitment to clinical excellence, patient support, and high-quality medical devices that help people breathe, speak, and live more comfortably.

We are seeking a Contracts & Credentialing Manager to join our team!

SUMMARY

The Contracts & Credentialing Manager oversees the management and maintenance of all government-funded and commercial insurance contracts, ensuring the company’s continued good standing. This role supervises the submission of new applications, re-credentialing activities, and updates to company demographics. The Manager also leads the implementation of newly enrolled contracts, ensuring that plan information is effectively communicated across departments, to owners, and to external vendors. Additionally, they ensure proper setup of payers in the system, supporting smooth and compliant operations. 

JOB RESPONSIBILITIES

Contracts:

• Oversee the preparation and analysis of financial data for health plan negotiations, ensuring the team maintains accuracy in utilization, cost, and reimbursement patterns.
• Analyze, manipulate, and interpret reimbursement data using Excel and other reporting tools to identify trends, model financial impacts, and support strategic business decisions related to payer agreements, pricing, and contract performance.
• Supervise the updating of health plan fee schedules in Excel, ensuring timely and accurate revisions.
• Manage the team’s processing of contracting inquiries, contributing to Brightree processes and reporting.
• Ensure team members handle requests from health plans and third-party payers efficiently and in compliance.
• Make sure contracts are entered into the database correctly, securely stored, and communicated across the organization.
• Supervise the management and updating of contracted health plans and payers, coordinating with external vendors, distributors, and partners.
• Ensure the team maintains contract-related materials and assists in distributing updates on new contracts or policy changes.

Credentialing:

• Oversee the processing and completion of credentialing and re-credentialing applications for all government-funded health plans, ensuring timely follow-up and monitoring of the application status.
• Supervise the processing of credentialing applications and initiatives for commercial health plans, ensuring all steps are completed accurately.
• Manage administrative tasks for all government-funded and commercial payer accounts, including web portal access, demographic updates, and certification renewals.
• Act as the administrator for state certifications/registrations, working closely with other departments to ensure compliance.
• Oversee the management of insurance reimbursement fee schedules in the Brightree Database, ensuring updates are communicated when rates change or new information becomes available.
• Ensure the team maintains compliance with all relevant federal, state, and local regulations, as well as internal policies and procedures.

Compliance, Policy & Regulatory Oversight

• Proactively monitor and stay current on federal, state, payer, accreditation, and industry regulations impacting DME operations, contracting, credentialing, reimbursement, and billing practices.
• Assess regulatory and payer policy changes for operational impact and communicate requirements to leadership and cross-functional teams.
• Develop, implement, maintain, and periodically review departmental policies, procedures, and work instructions to ensure ongoing regulatory and contractual compliance.
• Partner with internal stakeholders to establish and strengthen compliance controls, processes, and documentation standards.
• Serve as a subject matter expert on contracting, credentialing, payer requirements, and DME compliance standards, providing guidance and training as needed.
• Identify opportunities for process improvement and standardization to mitigate risk, improve operational efficiency, and support ongoing compliance.

Team Management & Leadership:

• Manage the team in their daily responsibilities, ensuring alignment with departmental goals.
• Facilitate reoccurring one-on-one meetings with applicable staff to provide coaching, support, and feedback.
• Lead monthly team meetings and coordinate one-on-one or group training sessions when necessary.
• Manage department staffing needs, including hiring, performance reviews, and scheduling.
• Approve timecards and PTO requests, ensuring proper coverage and adherence to policies.
• Monitor and enhance individual and team performance through regular evaluations, feedback, and recognition.

Collaboration & Culture:

• Serve as a liaison between internal and external parties to ensure alignment with and achievement of business goals.
• Foster a collaborative work environment across all functional areas within Atos Medical and the broader Coloplast Group
• Foster an environment of teamwork, recognition, and engagement

Other:

• Perform other duties and responsibilities as assigned to support departmental objectives and evolving business needs.

SKILLS & ABILITIES

• Exhibits and models strong leadership skills, integrity, and reliability.
• Strong communication and conflict resolution skills. 
• Excellent customer service skills and professional attitude. 
• Ability to effectively train and develop employees. 
• Strong ability to collaborate effectively within a team and work cross-functionally across the organization.
• Strong understanding of fraud, waste, and abuse compliance considerations and the heightened oversight applicable to DME suppliers.
• Strong organizational and analytical skills with the ability to manage multiple payer requirements, regulatory deadlines, and complex changes simultaneously.
• Experience managing multi-state Medicaid enrollment and revalidation, including off-cycle revalidations, enhanced screening, and site visits.
• Excellent communication skills and experience working cross-functionally with Legal, Compliance, Revenue Cycle, Finance, and operational teams.
• Proficiency in relevant technical tools and software, with the ability to quickly learn and adapt to new technologies and systems.
• Working knowledge of CMS/PECOS enrollment, revalidations, ownership disclosures, and change-of-information requirements.
• DME/DMEPOS experience strongly preferred, including knowledge of the regulatory and payer requirements specific to DME suppliers.
• Intermediate proficiency in Microsoft Excel with the ability to analyze and manipulate data to support contract analysis and business decisions.
• Experience with Brighttree, Salesforce, and Smartsheet highly preferred

BASIC QUALIFICATIONS

• High school diploma OR equivalent
• 3+ years of relevant Contracts & Credentialing experience with Medicare, Medicaid and commercial insurance.
• 1-2+ years of people management experience OR demonstrated experience mentoring and training employees

PREFERRED QUALIFICATIONS

• Bachelor’s Degree in related industry
• 3-5 years of Contracts & Credentialing within the Durable Medical Equipment (DME) industry
• 3+ years of people management experience
• Knowledge of Salesforce, Brightree and MS Office products

WE OFFER

Atos Medical is a global leader headquartered in Sweden, united by a shared purpose and strong values. Guided by our superpowers—patient-centric, dedication, agile, and the belief that you never walk alone—we support and empower our users, our colleagues, and our partners every day. We believe in working together, growing together, and treating everyone we interact with—patients, coworkers, health care professionals, and partners—with respect and integrity.

You will be part of an ambitious work environment in which teams work together to continuously grow and develop the business. You will have great opportunities to learn and develop, and you will be offered a competitive salary package and benefits.

TOTAL REWARDS

At Atos Medical, a Coloplast company, we value and reward the contributions of our employees. Our total rewards package supports your well-being, professional growth, and work-life balance. Here's what you can expect:

Health & Wellness: 

• • Comprehensive medical, dental, and vision coverage for you and your family.
  • Access to company-sponsored wellness programs and mental health resources
  • Paid leave for qualifying events, and generous parental leave for both birthing and non-birthing parents.
  • Health Savings Account (HSA) with employer contributions

Financial Security: Competitive 401(k) with company match, financial planning services, and corporate discounts.

State-of-the-art facility: Hybrid and onsite employees work from our state-of-the-art facility, thoughtfully designed with sit-stand desks, large monitors, and premium onsite amenities, including a gym and golf simulator.

Work-Life Balance: Flexible work options, Generous PTO plan, 10 paid holidays, and summer hours to help you recharge.

Professional Development: Ongoing learning and career growth opportunities through training, mentorship, and tuition reimbursement.

Community & Culture: Join a Top Workplace, as recognized by USA Today and the Milwaukee Journal Sentinel. We foster a supportive environment where everyone feels valued and included. Engage in team-building, volunteer events, and our sustainability initiatives.

Atos Medical, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. To request reasonable accommodation to participate in the job application, please contact 800-217-0025.

Founded in 1986, Atos Medical is the global leader in laryngectomy care as well as a leading developer and manufacturer of tracheostomy products. We are passionate about making life easier for people living with a neck stoma, and we achieve this by providing personalized care and innovative solutions through our brands Provox®, Provox Life™ and Tracoe.

We know that great customer experience involves more than first-rate product development, which is why clinical research and education of both professionals and patients are integral parts of our business. 

Our roots are Swedish but today we are a global organization made up of about 1400 dedicated employees and our products are distributed to more than 90 countries. As we continue to grow, we remain committed to our purpose of improving the lives of people living with a neck stoma.

Since 2021, Atos Medical is the Voice and Respiratory Care division of Coloplast A/S

62376 
#LI-AT #LI-Remote