Licensing and Credentialing Specialist
Description
Who we are
CirrusMD, now part of Quantum Health, is redefining virtual care through a Physician-first Care & Guidance solution that meets patients at their moment of need. Our text-based and web app connects patients with licensed physicians in under a minute, enabling care that is convenient, continuous, and personalized. Available 24/7/365, CirrusMD delivers integrated care across acute, chronic, and behavioral health needs. Serving more than 10 million members nationwide through employers and health plans, we are proud to expand our impact as part of Quantum Health—combining innovative virtual care with industry-leading healthcare navigation to create a more connected, member-centered experience.
About the role
CirrusMD is seeking a Licensing and Credentialing Specialist who, under limited supervision, will support the CirrusMD Provider Network’s (CMDPN) licensing and credentialing functions. The job will focus on the management and monitoring processes and procedures that support the initial application and renewals of state medical licensing. Additional tasks may include insurance & Medicaid plan enrollment processes. Ensure compliance with the appropriate accredited and regulatory agencies. This opportunity reports to the Senior Director of Clinical Operations.
Location: This position may work remotely anywhere in the United States of America.
What you’ll do (Essential Responsibilities)
Licensing
Manages the CirrusMD Provider Network (CMDPN) licensing process for all CirrusMD clinical providers, in accordance with Federal and State laws, and CirrusMD policies.
Coordinates and works with the licensing database, ensuring accuracy of data and reporting to partnering systems. Monitors critical data for extensive analysis and report generation.
Works closely with physicians to successfully gather necessary information and forms for State Medical licensing applications. Communicates the status of licensing work
Complete applications through to submission and approval for any work not assigned externally.
Monitors and reports turnaround times of state medical licensing approval across all 50 states.
Manages licensing procedures; develops, recommends, and/or implements changes, revisions, and enhancements as appropriate to the current operating environment.
Credentialing
Support the CMDPN credentialing process for all CirrusMD clinical providers, in accordance with NCQA, Delegated contracts and CMS accreditation standards, Federal and State laws, and CirrusMD policies.
Help to coordinate the management of the expirables process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
Function as a CMDPN credentials contact for all internal and external inquiries; develops and maintains positive working relationships.
Represents CMDPN to internal and external customers as appropriate.
All other duties assigned.
What you’ll bring (Qualifications)
Experience: 3-5 year of experience in licensing and credentialing preferred
Licensure/Certification: NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM) or Ability to make administrative/procedural decisions and judgments.
Proven ability to work independently, seeking help as necessary.
Proven ability to investigate and analyze information and draw conclusions.
Ability to develop and deliver presentations.
Ability to process computer data and to format and generate reports.
Ability to communicate effectively, both orally and in writing.
Ability to foster a cooperative work environment.
Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
Skill in developing policy and procedure documentation.
Database management skills.
Employee development and performance management skills.
Knowledge of related accreditation and certification requirements.
Knowledge of medical credentialing and privileging procedures and standards.
Knowledge of medical staff policies, regulations, and bylaws and the legal environment within which they operate.
#LI-HW1 #LI-Remote
What’s in it for you
- Compensation: Competitive base and incentive compensation
- Coverage: Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc services and more.
- Retirement: 401(k) plan with up to 4% employer match and full vesting on day one.
- Balance: Paid Time Off (PTO), 7 paid holidays, parental leave, volunteer days, paid sabbaticals, and more.
- Development: Tuition reimbursement up to $5,250 annually, certification/continuing education reimbursement, discounted higher education partnerships, paid trainings and leadership development.
- Culture: Recognition as a Best Place to Work for 15+ years, dedication to diversity, philanthropy and sustainability, and people-first values that drive every decision.
- Environment: A modern workplace with a casual dress code, open floor plans, full-service dining, free snacks and drinks, complimentary 24/7 fitness center with group classes, outdoor walking paths, game room, notary and dry-cleaning services and more!
What you should know
- Internal Associates: Already a Healthcare Warrior? Apply internally through Jobvite.
- Process: Application > Phone Screen > Online Assessment(s) > Interview(s) > Offer > Background Check.
- Diversity, Equity and Inclusion: Quantum Health welcomes everyone. We value our diverse team and suppliers, we’re committed to empowering our ERGs, and we’re proud to be an equal opportunity employer .
- Tobacco-Free Campus: To further enable the health and wellbeing of our associates and community, Quantum Health maintains a tobacco-free environment. The use of all types of tobacco products is prohibited in all company facilities and on all company grounds.
- Compensation Ranges: Compensation details published by job boards are estimates and not verified by Quantum Health. Details surrounding compensation will be disclosed throughout the interview process. Compensation offered is based on the candidate’s unique combination of experience and qualifications related to the position.
- Sponsorship: Applicants must be legally authorized to work in the United States on a permanent and ongoing future basis without requiring sponsorship.
- Agencies: Quantum Health does not accept unsolicited resumes or outreach from third-parties. Absent a signed MSA and request/approval from Talent Acquisition to submit candidates for a specific requisition, we will not approve payment to any third party.
Reasonable Accommodation: Should you require reasonable accommodation(s) to participate in the application/interview/selection process, or in order to complete the essential duties of the position upon acceptance of a job offer, click here to submit a recruitment accommodation request.
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