Licensing and Credentialing Specialist

Job not on LinkedIn

🔥 0 minutes ago

🌵 Arizona, Florida, +15 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🥔 Idaho – Remote ⚜️ Louisiana – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌲 North Carolina – Remote 🚗 Michigan – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote 🧀 Wisconsin – Remote

💵 $65k - $75k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Connecting for Better Health

WebsiteLinkedInAll Job Openings

1 - 10 employees

Founded 2021

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

Connecting for Better Health is a nonprofit coalition dedicated to improving health and social service data sharing in California. The organization brings together providers, caregivers, health plans, advocates, and community organizations to collaborate on enhancing data sharing policies. Their initiative promotes the Data Exchange Framework (DxF), which aims to facilitate secure and efficient exchanges of health and social services information to support better whole-person care.

📋 Description

• Own the end-to-end payer enrollment process for new and existing providers, including initial enrollments, revalidations, demographic updates, terminations, and maintenance across commercial, Medicare, and Medicaid health plans • Submit, track, and proactively follow up on payer enrollment applications • Serve as the primary point of contact with health plans, delegated credentialing organizations, CVOs, and internal stakeholders to resolve enrollment issues and escalations • Maintain accurate provider data across payer portals, CAQH, credentialing systems, and internal tracking tools • Support delegated credentialing activities, provider rosters, compliance monitoring, and audit documentation • Conduct routine audits of provider enrollment and credentialing files for NCQA, CMS, state, and payer-specific compliance • Monitor enrollment and credentialing metrics, identify risks, and communicate status updates to leadership and cross-functional partners • Collaborate with Licensing, Practice Operations, Revenue Cycle, Recruiting, and Clinical Operations teams • Improve enrollment and credentialing workflows through standardization, documentation, automation, and operational efficiencies • Support new state license applications, renewals, cross-licensure efforts, and licensure record maintenance • Monitor provider licenses, DEA and CDS registrations, board certifications, malpractice coverage, and other required credentials • Support providers throughout enrollment, credentialing, and licensing by communicating requirements, timelines, and next steps

🎯 Requirements

• Bachelor’s Degree in Healthcare administration or related field • 3+ years of experience in provider payer enrollment and credentialing • Experience managing provider enrollments with commercial, Medicare, and Medicaid payers • Experience supporting delegated credentialing activities, including provider rosters, ongoing monitoring, or audit preparation • Experience with multi-state or national provider organizations • Working knowledge of CAQH, payer portals, and provider credentialing systems • Understanding of NCQA, CMS, state licensing, and payer credentialing requirements • Strong organizational skills with the ability to manage multiple priorities and deadlines • Excellent attention to detail and written and verbal communication skills • Proficiency with Google Workspace, including Google Sheets • CPCS certification or equivalent credential preferred • 1+ year working in Verifiable Enrollment and Licensing Manager • Experience supporting delegated credentialing audits and corrective action plans • Familiarity with provider licensing and cross-state licensure • Experience working with credentialing vendors (CVOs) • Experience in a virtual care or telehealth environment • Experience working in a fast-paced, high-growth startup environment • Process improvement mindset with experience documenting or streamlining workflows • Must currently reside and plan on residing throughout employment in one of: Arizona, Delaware, Florida, Georgia, Idaho, Indiana, Louisiana, Michigan, Missouri, New Hampshire, New Jersey, North Carolina, Rhode Island, Pennsylvania, South Carolina, Tennessee, Texas, Vermont, Virginia, or Wisconsin • Monday-Friday, 9-6pm EST schedule

🏖️ Benefits

• Salary Range: 65,000-75,000 per year plus bonus eligibility • Employer-sponsored medical, dental, and vision coverage • Flexible Time Off + 11 paid company holidays + 1 floating holiday • Eligibility to contribute to 401(k) • Remote-first — work from home within approved states • Tailored professional development opportunities as we scale • Access to Overalls, because we know life happens