Director, Provider Licensure, Credentialing & Compliance

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Develop plans for licensure, registration, and collaboration coverage across new states, programs, and provider types.

• Manage the provider compliance risk framework and execute mitigation strategies and controls.

• Create governance structures through policies, procedures, key performance indicators (KPIs), escalation protocols, and decision-making authorities.

• Provide reports on provider readiness, licensing status, state coverage, emerging risks, and compliance performance metrics.

• Supervise initial, additional-state, renewal, and reinstatement licensure for value-based care (VBC) clinicians.

• Keep records of licenses, certifications, credentialing statuses, and state-specific registrations.

• Monitor continuing medical education (CME) and continuing education requirements, integrating them into renewal processes.

• Coordinate payer credentialing and enrollment efforts.

• Act as the operational authority regarding state-specific collaboration, supervision, delegation, scope-of-practice, and physician-to-APP ratio standards.

• Establish and uphold collaborative or supervisory relationships, agreements, delegation documents, and practice protocols.

• Maintain an auditable system for tracking physician-APP meetings, chart reviews, clinical record audits, and attestations.

• Handle state board reporting, filings, notifications, and attestations.

• Build and sustain a centralized provider compliance framework and a single source of truth.

• Transform regulatory requirements into actionable tasks, due dates, workflows, alerts, and escalation guidelines.

• Oversee credentialing and compliance tracking platforms, collaborating with Product/Technology to automate workflows.

• Develop dashboards and exception reports.

• Lead regulatory change management efforts and update workflows, agreements, policies, and system logic accordingly.

• Ensure audit-ready provider records; conduct internal audits and manage corrective actions and regulatory responses.

• Lead, develop, and retain a team of 1–2 direct reports.

• Mentor team members through feedback, goal-setting, and professional growth.

• Identify opportunities for automation, process streamlining, and work redistribution.

• Collaborate with Operations, Clinical Leadership, Legal/Compliance, Credentialing, Human Resources, and Product/Technology.

⛳️ Requirements

• A bachelor's degree in healthcare administration, business administration, nursing, health sciences, compliance, or a related field is required.

• An equivalent combination of education and extensive relevant experience may be accepted.

• 5–7 years of progressive experience in provider licensure, credentialing, provider compliance, medical staff services, telehealth operations, or a related healthcare function.

• Minimum of 3 years in a leadership position with direct people-management responsibilities.

• Experience in strategic planning, risk assessment, and establishing compliance governance, including policies, controls, and KPIs.

• Familiarity with requirements for clinicians practicing in multiple states.

• Experience in administering collaboration, supervision, delegation, or similar APP practice requirements.

• Proven experience working with state medical boards, nursing boards, and other professional licensing authorities.

• Ability to manage credential expirations, renewals, continuing education requirements, board filings, and regulatory reporting.

• Strong understanding of healthcare provider licensure and credentialing processes.

• In-depth knowledge of state-specific physician, NP, and PA practice requirements.

• Awareness of state medical and nursing board processes, reporting requirements, and regulatory expectations.

• Understanding of telehealth and multi-state clinical practice considerations.

• Knowledge of compliance governance, risk management, internal controls, audit documentation, record retention, and regulatory change-management processes.

• Strong strategic planning and executive communication abilities.

• Proven leadership skills in hiring, coaching, and managing team performance.

• Excellent organizational, project management, analytical, written, and verbal communication skills.

• Skill in converting complex regulatory requirements into practical workflows and measurable controls.

• Ability to manage multiple concurrent deadlines while ensuring accuracy and regulatory compliance.

• Capacity to collaborate across clinical, operational, technical, legal, compliance, and administrative functions.

🏝️ Benefits

• Full-time employment.

• Some travel may be required for organizational meetings, provider meetings, or other business-related purposes.