Director, Provider Licensure, Credentialing & Compliance

🔥 14 hours ago

🌵 Arizona – Remote

🌵 Arizona – Remote

⏰ Full Time

🔴 Lead

🚔 Compliance

👻 Ghost score 10%

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Healthcare Outcomes Performance Co. (HOPCo)

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

🤝 B2B

☁️ SaaS

💰 Private equity on 2019-02

Healthcare • B2B • SaaS

Healthcare Outcomes Performance Co. (HOPCo) is the largest orthopedic value-based care organization in the U. S. , specializing in comprehensive musculoskeletal (MSK) care delivery, management, and value creation. Led by orthopedic physicians and executives, HOPCo operates an accredited MSK clinically integrated network and offers practice partnership and health system solutions, payor-facing population health and value-based care programs, analytics and outcomes reporting, and digital patient engagement tools to align stakeholders, improve outcomes, and lower total MSK costs.

📋 Description

• Plan licensure, registration, and collaboration coverage for new states, programs, and provider types • Oversee the provider compliance risk framework and implement mitigation plans and controls • Establish governance through policies, procedures, KPIs, escalation protocols, and decision rights • Report on provider readiness, licensing status, state coverage, emerging risks, and compliance performance • Oversee initial, additional-state, renewal, and reinstatement licensure for VBC clinicians • Maintain records of licenses, certifications, credentialing status, and state-specific registrations • Track CME and continuing education requirements and incorporate them into renewal workflows • Coordinate payer credentialing and enrollment activities • Serve as operational authority on state-specific collaboration, supervision, delegation, scope-of-practice, and physician-to-APP ratio requirements • Establish and maintain collaborative or supervisory relationships, agreements, delegation documents, and practice protocols • Track physician-APP meetings, chart reviews, clinical record audits, and attestations in an auditable system • Manage state board reporting, filings, notifications, and attestations • Build and maintain a centralized provider compliance framework and single source of truth • Convert regulatory requirements into tasks, due dates, workflows, alerts, and escalation rules • Own credentialing and compliance tracking platforms and partner with Product/Technology to automate workflows • Develop dashboards and exception reporting • Lead regulatory change management and update workflows, agreements, policies, and system logic • Maintain audit-ready provider records; conduct internal audits and lead corrective actions and regulatory responses • Lead, develop, and retain a team of 1–2 direct reports • Coach team members through feedback, goal setting, and professional development • Identify automation, streamlining, and work-redistribution opportunities • Partner with Operations, Clinical Leadership, Legal/Compliance, Credentialing, Human Resources, and Product/Technology

🎯 Requirements

• Bachelor’s degree in healthcare administration, business administration, nursing, health sciences, compliance, or a related field required • Equivalent combination of education and substantial relevant experience may be considered • 5–7 years of progressive experience in provider licensure, credentialing, provider compliance, medical staff services, telehealth operations, or a related healthcare function • At least 3 years in a leadership role with direct people-management responsibility • Experience in strategic planning, risk assessment, and building compliance governance, including policies, controls, and KPIs • Experience managing requirements for clinicians practicing across multiple states • Experience administering collaboration, supervision, delegation, or similar APP practice requirements • Experience working with state medical boards, nursing boards, and other professional licensing authorities • Experience managing credential expirations, renewals, continuing education requirements, board filings, and regulatory reporting • Strong knowledge of healthcare provider licensure and credentialing processes • Strong knowledge of state-specific physician, NP, and PA practice requirements • Knowledge of state medical and nursing board processes, reporting requirements, and regulatory expectations • Understanding of telehealth and multi-state clinical practice considerations • Understanding of compliance governance, risk management, internal controls, audit documentation, record retention, and regulatory change-management processes • Strategic planning and executive communication skills • Proven people-leadership skills, including hiring, coaching, and managing team performance • Strong organizational, project-management, analytical, written, and verbal communication skills • Ability to translate complex regulatory requirements into practical workflows and measurable controls • Ability to manage multiple concurrent deadlines while maintaining accuracy and regulatory compliance • Ability to collaborate across clinical, operational, technical, legal, compliance, and administrative functions

🏖️ Benefits

• Full-time employment • Some travel, as needed, for organizational meetings, provider meetings, or other business purposes

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