Licensing and Credentialing Specialist

Connecting for Better Health

. Own the end-to-end payer enrollment process for new and existing providers, including initial enrollments, revalidations, demographic updates, terminations, and maintenance across commercial, Medicare, and Medicaid health plans .

Posted 9/18/2026full-timeRemote • Arizona • United StatesMid-LevelSenior💰 $65,000 - $75,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing the end-to-end payer enrollment process, including compliance with NCQA, CMS, and state licensing requirements. Proficient in utilizing credentialing systems and payer portals to maintain accurate provider data and improve workflows.

Highest-signal resume keywords

Payer Enrollment ManagementCredentialing ComplianceCAQH ProficiencyProcess ImprovementCPCS Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider EnrollmentCredentialing ActivitiesAudit PreparationMulti-State Provider ManagementData ManagementWorkflow DocumentationLicensure MaintenanceEnrollment Metrics MonitoringCompliance MonitoringProvider Roster Management

Soft Skills

Organizational SkillsAttention to DetailWritten CommunicationVerbal CommunicationTime Management

Tools & Technologies

Google WorkspaceCredentialing SystemsPayer PortalsCAQHTracking Tools

Certifications & Qualifications

CPCS Certification

Industry Keywords

Healthcare AdministrationMedicareMedicaidVirtual CareTelehealthProvider LicensingDelegated CredentialingCompliance StandardsEnrollment ProcessesHigh-Growth Startup

About the role

Key responsibilities & impact

Own the end-to-end payer enrollment process for new and existing providers, including initial enrollments, revalidations, demographic updates, terminations, and maintenance across commercial, Medicare, and Medicaid health plans
Submit, track, and proactively follow up on payer enrollment applications
Serve as the primary point of contact with health plans, delegated credentialing organizations, CVOs, and internal stakeholders to resolve enrollment issues and escalations
Maintain accurate provider data across payer portals, CAQH, credentialing systems, and internal tracking tools
Support delegated credentialing activities, provider rosters, compliance monitoring, and audit documentation
Conduct routine audits of provider enrollment and credentialing files for NCQA, CMS, state, and payer-specific compliance
Monitor enrollment and credentialing metrics, identify risks, and communicate status updates to leadership and cross-functional partners
Collaborate with Licensing, Practice Operations, Revenue Cycle, Recruiting, and Clinical Operations teams
Improve enrollment and credentialing workflows through standardization, documentation, automation, and operational efficiencies
Support new state license applications, renewals, cross-licensure efforts, and licensure record maintenance
Monitor provider licenses, DEA and CDS registrations, board certifications, malpractice coverage, and other required credentials
Support providers throughout enrollment, credentialing, and licensing by communicating requirements, timelines, and next steps

Requirements

What you’ll need

Bachelor’s Degree in Healthcare administration or related field
3+ years of experience in provider payer enrollment and credentialing
Experience managing provider enrollments with commercial, Medicare, and Medicaid payers
Experience supporting delegated credentialing activities, including provider rosters, ongoing monitoring, or audit preparation
Experience with multi-state or national provider organizations
Working knowledge of CAQH, payer portals, and provider credentialing systems
Understanding of NCQA, CMS, state licensing, and payer credentialing requirements
Strong organizational skills with the ability to manage multiple priorities and deadlines
Excellent attention to detail and written and verbal communication skills
Proficiency with Google Workspace, including Google Sheets
CPCS certification or equivalent credential preferred
1+ year working in Verifiable Enrollment and Licensing Manager
Experience supporting delegated credentialing audits and corrective action plans
Familiarity with provider licensing and cross-state licensure
Experience working with credentialing vendors (CVOs)
Experience in a virtual care or telehealth environment
Experience working in a fast-paced, high-growth startup environment
Process improvement mindset with experience documenting or streamlining workflows
Must currently reside and plan on residing throughout employment in one of: Arizona, Delaware, Florida, Georgia, Idaho, Indiana, Louisiana, Michigan, Missouri, New Hampshire, New Jersey, North Carolina, Rhode Island, Pennsylvania, South Carolina, Tennessee, Texas, Vermont, Virginia, or Wisconsin
Monday-Friday, 9-6pm EST schedule

Benefits

Comp & perks

Salary Range: 65,000-75,000 per year plus bonus eligibility
Employer-sponsored medical, dental, and vision coverage
Flexible Time Off + 11 paid company holidays + 1 floating holiday
Eligibility to contribute to 401(k)
Remote-first — work from home within approved states
Tailored professional development opportunities as we scale
Access to Overalls, because we know life happens