Lead and supervise credentialing support staff, ensuring quality, accuracy, and timely processing of credentialing and enrollment tasks.
Oversee provider credentialing, licensure, and internal enrollment with Medicare, Medicaid, Managed Care, and Commercial Plans.
Maintain provider rosters, monitor license and certification renewals, and ensure compliance with regulatory and internal standards.
At Better Life Partners, we provide what it takes to heal from addiction. Wherever. Whenever. By combining virtual and in-person counseling, community support, and medication access.
Manage all aspects of provider licensing, credentialing, and payer enrollment.
Coordinate end-to-end licensing workflows and maintain accurate records.
Act as a key liaison between clinicians, state boards, payers, and internal stakeholders.
They are committed to providing safe, discreet medication abortion treatment and offer a range of reproductive and sexual health care services. The in-house clinical care team composed of board-certified doctors, advanced practice clinicians, nurses, and patient care advocates, is just a text message away.
The Provider Enrollment Specialist is responsible for timely and effectively enrolling practitioners in health plans. The Specialist will monitor progress, ensure timeliness of enrollment completion, and provide updates. The Specialist will maintain accurate provider profiles in IntelliCred and CAQH.
Pediatrix Medical Group is one of the nation’s leading providers of specialized health care for women, babies and children since 1979.
Manage contracting and credentialing activities with insurance companies and Medicaid agencies. Oversee the provider enrollment, application, and credentialing process. Serve as the point of contact for contract negotiations and expedite approvals.
Amity Foundation is a safe place where people can change in an environment that fosters trust; where new values can be formed, responsibility developed, and lasting relationships built.
Oversee the operations of the Imagine Pediatrics Onboarding, Credentialing, Licensing, and Enrollment Department. Develop and train on policies and procedures, workflows, and training documentation for the team. Manage Delegated Credentialing arrangements - implementation and audit – as well as ongoing Delegated partnerships with health plans.
Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs.
Ensuring providers are credentialed in a timely manner by monitoring the submission process.
Monitoring submission processes, updating protocols, and managing Virtual Assistants/BPO.
Communicating with payors and conducting regular reviews to validate internal credentialing data.
Grow Therapy aims to be the trusted partner for therapists growing their practice, and patients accessing high-quality care. They are a three-sided marketplace that empowers providers, augments insurance payors, and serves patients and have empowered more than ten thousand therapists.
Manage the day-to-day tasks of processing provider credentials, licenses and payor enrollment applications.
Work cross-functionally with many teams to guarantee the smooth running of operations.
Research, interpret, and evaluate information relevant to provider licensure and continuing medical education in the United States
CertifyOS is building the infrastructure that powers the next generation of provider data products, making healthcare more efficient, accessible, and innovative.
Acts as key point of contact for the processing of enrollment applications for all providers. Works with System Credentialing and local medical staff contacts. Responsible for completing the ongoing review and attestation of all Munson Healthcare provider enrollment records.
Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents.
Responsible for the strategic oversight, execution, and continuous improvement of all provider credentialing, re-credentialing, payer enrollment, contracting coordination, and licensure activities across all AnswersNow business entities.
Ensures that providers and groups are credentialed, contracted, and licensed accurately and on time so that services may be delivered, billed, and reimbursed without delay.
Leads the credentialing team, manages external vendors, partners cross-functionally with RCM, growth, operations, scheduling, and technology teams, and delivers clear, data-driven reporting to executive leadership.
AnswersNow is innovating autism therapy by making it more immediate, accessible, and effective for families. Their remote team allows for a flexible work-from-home environment, providing client support without the need to report on-site.
Lead payer credentialing and re-credentialing processes for healthcare providers.
Ensure compliance with accreditation standards, regulatory requirements, and organizational policies.
Oversee payer enrollments, manage the payer credentialing team, maintain data accuracy, and streamline provider onboarding.
Theoria Medical provides comprehensive medical group and technology solutions to serve patients across the care continuum, with an emphasis on post-acute and primary care. They aim to improve the quality of care delivered, refine facility processes, and enhance critical relationships, serving facilities across the United States.
Lead the preparation and submission of comprehensive provider rosters to Managed Medicare, Medicaid, and commercial payers.
Audit internal provider data against database records to ensure 100% accuracy before submission.
Serve as the primary point of contact for health plans to resolve roster discrepancies, rejections, or paneling delays.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs.
Facilitate all aspects of required medical licensure for clinical personnel.
Drive the licensing process in a proactive, organized and streamlined manner.
Collaborate with credentialing, onboarding, and clinical teams.
Talkiatry is a national mental health practice co-founded by a patient and a triple-board-certified psychiatrist. They provide patients with the care they need and allow psychiatrists to focus on medicine with innovative technology and a human-centered philosophy.
Be the primary point of contact for all providers.
Provide professional, accurate and timely responses to all provider inquiries.
Maintain a current knowledge of all contract requirements and objectives.
Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans.
Lead a team of Credentialing Specialists and Operational Analysts to ensure efficient credentialing file processing. Provide coaching and training to strengthen credentialing knowledge and regulatory understanding. Monitor contractual Service Level Agreements, turnaround times, and quality metrics; drive corrective actions to maintain compliance.
Certify is on a mission to change how the US healthcare industry deals with provider data, aiming to reduce healthcare costs by streamlining access to this data.
Provides data management support services to Dignity Health’s CI/ACO Networks, Employer Relations and Valued Based Operations (VBO).
Within the Salesforce platform, this individual gathers and maintains accurate provider data, performs periodic provider data reconciliations with multiple data sources.
Maintains and transmits fee schedules, as necessary, to third-party administrators (TPA's) and other appropriate stakeholders.
Dignity Health MSO builds a system-wide integrated physician-centric, full-service management service organization structure. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers.
Own the end-to-end cycle of licensing applications for new and existing providers across the U.S., ensuring all requirements are met for licenses to be approved.
Support efforts to streamline existing licensing processes by providing suggestions for automation or new tools, optimizing individual steps, and ensuring smooth workflows.
Develop SOPs (detailed guides) for new state or provider licensing, and own the implementation across the team.
Nourish aims to improve people’s health by making it easy to eat well. Nutrition-related chronic disease is the largest and most overlooked crisis in the world, and they are building an AI-native, patient-friendly healthcare system centered on nutrition. They are live in all 50 states, and have thousands of dietitians and hundreds of thousands of patients on the platform.
Establish and maintain licensing processes for Physicians, Nurses, and Licensed Mental Health providers.
Monitor progress and approval of submitted licenses ensuring timely completion.
Serve as the primary point of contact for all matters related to licensing.
TimelyCare provides virtual medical and mental health support. They foster a supportive team culture with a mission-driven purpose and are an equal opportunity employer.
Provide utilization management services, transition of care, and support to members and health care providers.
Utilize clinical knowledge to interpret medical policy and provide consultation on UM requests.
Proactively assess and assist members through the continuum of care by utilizing services and resources efficiently.
Wellmark is a mutual insurance company owned by its policy holders across Iowa and South Dakota, and it has built its reputation on over 80 years of trust.