Credentialing and Licensing Supervisor

We are looking for a motivated, organized, and talented Credentialing and Licensing Supervisor to join our team, focusing on ensuring the creation, completeness, and maintenance of credentialing and licensure files for the medical practice and its medical staff members so the practice can operate and staff members can work legally in their field or specialty and properly bill payer sources for their services. Become part of a team where your power to improve lives is exponential.

Job Purpose:

Responsible to serve as a subject matter expert for credentialing and licensing, with attention to essential changes and required actions to ensure compliance across all state and federal requirements. This role will specialize in the Licenses that employees and contractors need in each state for their specific career field. This role is mainly in charge of Provider licenses, credentialing, and the entity licensing required for operations. The Credentialing and Licensing Supervisor will monitor the credential status of our providers and be proactive in renewals as well as identifying opportunities for further licensing. The role will also be in charge of maintaining the licensure and certification needed to operate in each state as required.

Responsibilities:

• Establishes, documents, and leads the licensing and credentialing process as we scale our medical staff across multiple states.
• Maintains a database of required licenses, certifications, and credentials of the medical team as well as required licenses and certificates of entities to operate.
• Serves as a knowledge expert of the needs to expand employees' and contractors' licensures with state requirements.
• Manages/maintains Physician/APP (Advance Practice Provider) collaboration agreements in each state.
• Ensures all appropriate documentation is completed and filed in compliance with appropriate entities including regulatory and accrediting bodies as well as payer sources including Medicare, Medicaid, and other insurance sources as well as government entities such as secretaries of state and boards of medicine.
• Identifies and flags gaps or potential risks. Monitors and addresses relevant timelines associated with expirations/renewals (ensuring recertification occurs timely).
• Provides necessary resources and deliverables to ensure effective management of the provider roster to mitigate any risks associated with growth and expansion as well as to drive efficiencies.
• Assists Human Resources in providing onboarding as it relates to primary source verification, initial credentialing, and other key requirements to inform key decisions on hiring and onboarding. HR will serve as the initial reviewer; the Credentialing and Licensing Supervisor is the final reviewer of the provider/applicant's licensing and medical credentialing applications to ensure compliance with each entity's specific requirements and standards including state and federal regulatory requirements.
• Releases information to agencies and members of the public as required by law.
• Participates in the development of internal credentialing processes.
• Performs other duties as assigned.

Here are our MUST HAVES:

Required Education, Experience, Certifications / Licensure, & Skills:

• Associate degree in business or related field and at least THREE to FIVE years of related experience or the equivalent combination of education and experience
• Meticulous with an attention to detail and accuracy
• Ability to follow instructions easily
• Timely
• Focused
• Responsive
• Knowledgeable in policies, laws and procedures
• Data entry / database / keyboarding and control skills
• Excellent organizational skills
• A self-starter, driven to accomplish exceptional results
• Excellent written and verbal communication skills and professional demeanor

Preferred Experience and Skills:

• CPCS Certification strongly preferred

Requirements:
Job Type (FLSA Status): Salaried, Non-Exempt

Pay: $66,500.00 to $81,500.00 per

Ability to commute/relocate: N/A

Work Location: Remote