Manager, Licensing – Credentialing

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

📋 Description

• Oversee Synapticure's licensing, credentialing, and payer enrollment operations.

• Manage the onboarding and offboarding of providers, which includes determining licensing pathways, assessing compact licensure, sequencing start dates, verifying transcripts/employment, tracking COI, screening for sanctions/exclusions, registering for the DEA, deactivating licenses and payer enrollments, deactivating supervision agreements, notifying payers, and archiving records.

• Support and supervise applications and renewals for multi-state provider licensing, ensuring the Master Licensing Sheet and State Coverage Maps are maintained.

• Facilitate payer enrollment and credentialing for Medicare, Medicaid, and commercial payers, which encompasses CAQH/Availity management, revalidations, and re-credentialing cycles.

• Keep track of APP restrictions, practice authority, and state board notifications to ensure regulatory compliance.

• Serve as the escalation point for intricate queries related to licensing, credentialing, billing, and operational care.

• Implement and uphold collaboration/supervision agreement tracking and regular drafting.

• Manage logistics for the Credentialing Committee, including scheduling, agendas, and documentation.

• Assist with payer contracting, denials, and appeals processes.

• Lead and mentor the Licensing & Credentialing team through workload management, feedback, performance evaluations, and professional growth.

• Establish team priorities, process standards, quality checks, and SOP Playbooks.

• Collaborate with the Director of Practice Operations to address team capacity, staffing, and workflow design.

• Maintain ownership of regulatory and compliance documentation and assist with audits.

• Track metrics related to license status, credentialing turnaround times, expirables, and payer rosters.

• Promote continuous improvement through the utilization of tracking technology, system enhancements, and automation.

• Lead communications, both internal and external, concerning licensing and enrollment status.

⛳️ Requirements

• A minimum of 5 years of direct, hands-on experience in state provider licensing, credentialing, and payer enrollment/revalidation processes.

• 2-3 years of experience in team leadership or management, overseeing a licensing and credentialing team or operational function.

• Comprehensive understanding of the U.S. healthcare landscape, including payers, regulatory frameworks, and telehealth care delivery models.

• Familiarity with compact licensure pathways: IMLC, PSYPACT, NLC, and APRN Compact.

• Exceptional organizational and documentation skills, with the ability to independently manage complex and detail-oriented processes.

• Experience with credentialing/licensing tracking software and CAQH/PECOS.

• Background in supporting CMS reimbursement programs or PC-MSO structures.

• CPCS or CPMSM certification, or actively pursuing such credentials.

• Experience in a multi-market, high-growth, or telehealth healthcare setting.

• Knowledge of automation or technology integrations aimed at streamlining credentialing workflows.

• Synapticure does not offer work visa sponsorship.

🏝️ Benefits

• Remote First: Work from any location within the 50 United States, with home office technology provided.

• Options for medical, dental, and vision insurance for you and your family.

• 401(k) plan with employer matching.

• Short- and long-term disability insurance.

• Basic and supplemental life insurance.

• 15 vacation days.

• 5 sick days.

• 12 paid holidays.

• 2 floating holidays.

• Fully paid company holiday break at the end of the year.

• Family-building and fertility services through Kindbody (where available) at a 20% discount.

• 24/7 mental health support through Health Advocate and Talkspace, including 12 free on-demand sessions per year.

• Access to One Medical.