- Manage full lifecycle licensing, credentialing, and re-credentialing applications for all Care Team members across multiple states.
- Build and execute Doula Readiness workflows to onboard non-traditional care providers efficiently into payer networks.
- Monitor and track clinical and non-clinical staff credentials, state license expiration dates, and mandatory Continuing Education Units (CEUs).
- Establish, standardize, and optimize internal credentialing and payer enrollment processes from scratch.
- Oversee the credentialing-to-claims bridge and collaborate with RCM and billing teams to prevent claim denials.
- Ensure regulatory compliance by monitoring licensure bodies, OIG exclusions, and NPDB reports.
- Serve as the functional point of contact for enterprise clients regarding provider panel status.
Project ManagementHIPAA