Licensing & Credentialing Specialist

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Requirements:

• Bachelor’s degree
• At least 2 years administrative experience, familiarity working in a healthcare startup strongly preferred
• Experience with clinician licensing preferred, specific experience with an emphasis on psychologists, clinical social workers, mental health counselors, and physicians
• Experience with payer enrollment and NCQA-compliant credentialing highly preferred, bonus points if you have used a credentialing platform or CVO previously
• Thorough knowledge of state and federal regulations related to mental health licensure and credentialing
• Very strong attention to detail and outstanding organization skills
• Excellent task management and communication skills, ability to work successfully across diverse teams
• Proactively take ownership of diverse projects and tasks
• Proficient in basic computer skills with a strong ability to learn and adapt to new technologies quickly

Responsibilities:

• Manage the end-to-end process of licensing applications, ensuring completeness and accuracy of documentation for our clinicians, including psychologists, social workers, counselors, and physicians
• Track and manage expirables where necessary
• Research and interpret state and federal regulations governing mental health services licensure to stay up to date with the latest regulations
• Develop and maintain a comprehensive understanding of licensing requirements across multiple jurisdictions to ensure compliance as the company expands geographically
• Coordinate the initial credentialing and re-credentialing processes for licensed providers
• Track and manage all payer enrollments as we add new payor contracts and expand to new states
• Monitor and update credentialing information to reflect status and changes
• Maintain a comprehensive database of provider credentials, ensuring accuracy and compliance with organizational policies and relevant regulations
• Support payor enrollment activities where required to ensure providers are properly set up in payor systems
• Maintain accurate and up-to-date records of all licensing and credentialing activities, including documentation of compliance with regulatory standards
• Conduct regular audits and reviews of licensing and credentialing records to identify discrepancies, gaps, or potential areas of non-compliance
• Collaborate closely with internal stakeholders, including clinical operations, legal, human resources, and finance teams, to ensure alignment of licensing and credentialing activities with organizational goals and objectives
• Serve as a subject matter expert on licensing and credentialing matters, providing guidance and support to internal teams as needed