Source Job

US

  • Manage provider credentialing, recredentialing, and enrollment processes including application review and verification.
  • Maintain credentialing files, databases, and tracking systems for license renewals, certifications, and DEA registrations.
  • Apply for provider participation with insurance networks, Medicare, Medicaid, and other payer panels, monitoring application status.

Credentialing Microsoft Office Medicaid Communication

20 jobs similar to Credentialing Specialist - CalAIM - Remote

Jobs ranked by similarity.

US 4w PTO 14w maternity 12w paternity

  • Manage end-to-end credentialing and recredentialing processes for healthcare providers.
  • Coordinate payer enrollment applications and ensure timely processing across commercial and government payers.
  • Maintain accurate credentialing files in compliance with regulatory standards and support cross-functional teams.

Knownwell is a weight-inclusive healthcare provider offering obesity care, primary care, nutrition counseling, and health coaching. Backed by $50M in funding from investors like CVS Health Ventures and a16z, they are scaling fast to expand access to evidence-based obesity care nationwide.

US

  • Manage provider credentialing, licensing, and payer enrollment activities from application through completion.
  • Research and resolve non-routine credentialing and provider data discrepancies, ensuring compliance.
  • Maintain accurate provider records, monitor deadlines, and communicate with stakeholders to prevent delays.

The company is a partner organization that manages hiring for healthcare credentialing roles. They operate remotely and foster a collaborative, deadline-driven culture focused on compliance and operational excellence.

US Unlimited PTO

  • Manage end-to-end credentialing and payer enrollment activities with minimal supervision.
  • Ensure provider readiness, accurate records, and compliant documentation across multiple systems.
  • Serve as a knowledgeable resource for less experienced team members and support cross-functional processes.

Our partner is a healthcare organization focused on credentialing and provider network management. They offer a mission-driven, inclusive environment with a focus on collaboration and continuous learning.

US Unlimited PTO

  • Collect, verify, and maintain provider credentials such as education, licensure, and malpractice insurance.
  • Enroll providers with Medicare, Medicaid, and commercial insurance payers.
  • Maintain provider profiles in CAQH and track credential expiration dates for timely renewals.

Foodsmart is a telenutrition and foodcare solution backed by a network of Registered Dietitians, guiding 2.2 million members toward healthier food choices. The company is a remote-first team with a mission-driven culture and recently secured a $200 million investment from TPG's Rise Fund.

US

  • Contribute directly to improving Provider experience through timely credentialing and enrollment.
  • Collaborate with cross-functional teams to support new payer launches and share operational insights.
  • Help educate credentialing associates as new processes and payers are introduced.

Rula is a remote-first company that makes mental health care more accessible by streamlining provider onboarding. The team values diversity, equity, and inclusion, fostering a culture of belonging.

US

  • Oversee the processing of initial payer applications to ensure compliance with accreditation standards and regulations.
  • Maintain and manage payer credentialing databases with accuracy and audit readiness.
  • Supervise payer credentialing staff by coordinating workloads, providing training, and monitoring performance.

Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care. They serve facilities across the United States, offering multispecialty physician services, telemedicine, and remote patient monitoring.

US

  • Manage the end-to-end credentialing process for assigned therapists, ensuring compliance with all requirements.
  • Review credentialing documents, complete primary source verifications, and maintain accurate records in multiple systems.
  • Partner with cross-functional teams to resolve issues and support timely onboarding.

Luna is revolutionizing the delivery of physical therapy by providing in-home care. The company is a start-up with a supportive leadership culture that offers opportunities for growth.

US Unlimited PTO

  • Credential providers end-to-end, managing high volumes of caseloads.
  • Pioneer best practices and new workflows for provider credentialing.
  • Collaborate cross-team to improve processes and policies.

Verifiable is a provider credentialing and network monitoring platform delivering AI, API, and software solutions to healthcare organizations. The company has grown to ~150 employees in 5 years, with a collaborative, high-ownership culture.

  • Coordinate credentialing, payer enrollment, and recredentialing for clinicians.
  • Maintain provider data across CAQH, NPPES, PECOS, and payer portals.
  • Track contracts, follow up with payers, and escalate delays to ensure billing readiness.

Legion Health is a full-stack, AI-native psychiatry network delivering mental health care at scale. It's a fast-paced startup focused on using AI to automate care operations, with a culture of adaptability and process improvement.

US

  • Verify healthcare providers' education, licenses, and credentials to ensure patients receive care from qualified professionals.
  • Maintain accurate records, track expiration dates, and ensure compliance with accrediting bodies and insurance companies.
  • Work closely with partners to deliver personalized service, coach team members, and lead by example.

Main Street Health is the nation's largest provider of value-based care exclusively serving rural America. We partner with rural health systems to bring high-quality care to patients, fostering a culture of entrepreneurial spirit, adaptability, and down-to-earth teamwork.

US

  • Submit and track provider enrollments with Medicare, Medicaid, and major commercial payers.
  • Maintain and update credentialing databases and payer status logs.
  • Collaborate with credentialing team and payer representatives to resolve blockers and shorten approval timelines.

Big Leap is a fast-growing, multi-state medical & behavioral clinician group focused on interventional mental health treatments like Spravato & TMS. The company is expanding its remote operations team to support growth.

US

  • You compile and maintain current and accurate data for dentists.
  • You complete credentialing and re-credentialing applications and monitor follow-ups.
  • You maintain copies of licenses, certifications, and other required documents.

We are a dental partnership organization dedicated to preserving the integrity of private practice. We currently serve patients in Oklahoma, Arkansas, Kansas, Missouri, and Nebraska and value team members who are motivated and detail-oriented.

US

  • Lead and develop a credentialing team, overseeing provider credentialing, licensing, and privileging processes.
  • Manage operational workflows, conduct audits, and implement improvements to ensure compliance and efficiency.
  • Collaborate with internal leadership, providers, and external clients to resolve issues and maintain high service levels.

Jobgether is an AI-powered recruitment platform that connects candidates with job opportunities through objective matching. It offers a fully remote, collaborative work environment with a focus on employee development and belonging.

US

  • Lead a pod of Credentialing or Enrollments Associates, setting priorities and ensuring quality.
  • Own complex payer enrollment and credentialing programs end to end.
  • Build scalable workflows and use metrics to manage capacity and execution risk.

Nourish is an AI-native digital health clinic that connects patients with dietitians and provides insurance-covered metabolic care. Founded four years ago, it has completed millions of appointments, tripled year-over-year, and partnered with health plans covering 200M+ Americans, with $215M in total funding.

US

  • Initiate and manage compliance onboarding for healthcare contractors, including credentialing verification.
  • Collaborate with staffing agencies and internal stakeholders to meet compliance deadlines.
  • Monitor credential expirations and maintain accurate records in the Vendor Management System.

Trio Workforce Solutions helps healthcare organizations manage workforce challenges through technology and services. The company is a mission-driven organization with a collaborative culture and growth opportunities nationwide.

US

  • Process state medical licenses for clinical professionals across multiple states.
  • Manage the full application lifecycle with medical boards, vendors, and clinicians.
  • Handle controlled substance, DEA, and malpractice insurance applications.

Curana Health is a national leader in value-based care for senior living communities, offering on-site primary care services and Medicare plans. Founded in 2021, it serves over 200,000 seniors across 1,500+ communities with more than 1,000 clinicians and was ranked #147 on the Inc. 5000.

$80,000–$90,000/yr
US Unlimited PTO

  • Own the licensing vendor relationship and budget, directing vendor performance and holding them accountable.
  • Manage payer credentialing end to end, ensuring providers are enrolled and revenue-ready.
  • Own payer roster management and develop relationships with payer representatives to resolve issues.

Brightline provides pediatric behavioral health care via virtual and in-person services, including therapy and psychiatry for kids up to age 18. Founded in 2019, the company has served tens of thousands of families and is nationally recognized for clinical excellence.

US

  • Submit provider and organizational contract requests to commercial, Medicare, Medicaid, and managed care payers.
  • Monitor contract application status and maintain detailed tracking of all submissions and negotiations.
  • Coordinate with internal teams to facilitate successful implementation of newly executed agreements.

Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services. Since 2019, we have served thousands of clients and maintain a fully remote culture focused on collaboration and personal connection.

US

  • Determine patient qualification for financial assistance programs and payment arrangements using confidential financial information.
  • Verify insurance coverage, obtain authorizations, and provide price estimates for scheduled procedures.
  • Serve as a liaison between patients, providers, and internal departments to coordinate benefits and collect patient portions.

CommonSpirit Health is a large healthcare system with over 700 care sites across the U.S., serving nearly one in four Americans. The culture emphasizes compassion, community health, and employee commitment to a greater cause.

Global

  • Manage electronic provider records to ensure accuracy, timeliness, and compliance with internal and external standards.
  • Handle licensing applications including DEA, CSR, and state licensure from start to finish, coordinating with providers and boards.
  • Communicate effectively with providers, state licensing boards, and agencies to facilitate timely credentialing and renewals.

Sevaro is a leading tele-neurology company that focuses on delivering innovative healthcare solutions to patients across the globe. The company culture emphasizes efficiency, compliance, and proactive collaboration in medical staff services.