About the Role
InStride Health is looking for a Licensing & Credentialing Specialist to support the licensing and credentialing process for InStride clinical providers. Partnering closely with the care and growth teams, the Licensing & Credentialing Specialist plays a key role in our ability to scale patient services and increase access.The ideal candidate will be responsible for ensuring that all healthcare professionals within our organization are properly licensed and credentialed to practice in accordance with state regulations and organizational standards and will also be able to provide ongoing support to existing providers.This position requires strong attention to detail, a proactive orientation to supporting our care team, ability to handle competing priorities, collaborative drive, and excellent task management skills.
Key Responsibilities
- Licensing
- Manage the end-to-end process of licensing applications, ensuring completeness and accuracy of documentation for our clinicians, including psychologists, social workers, counselors, and physicians
- Track and manage expirables where necessary
- Research and interpret state and federal regulations governing mental health services licensure to stay up to date with the latest regulations
- Develop and maintain a comprehensive understanding of licensing requirements across multiple jurisdictions to ensure compliance as the company expands geographically
- Credentialing
- Coordinate the initial credentialing and re-credentialing processes for licensed providers
- Track and manage all payer enrollments as we add new payor contracts and expand to new states
- Monitor and update credentialing information to reflect status and changes
- Maintain a comprehensive database of provider credentials, ensuring accuracy and compliance with organizational policies and relevant regulations
- Support payor enrollment activities where required to ensure providers are properly set up in payor systems
- Documentation and Compliance
- Maintain accurate and up-to-date records of all licensing and credentialing activities, including documentation of compliance with regulatory standards
- Conduct regular audits and reviews of licensing and credentialing records to identify discrepancies, gaps, or potential areas of non-compliance
- Cross-functional Collaboration
- Collaborate closely with internal stakeholders, including clinical operations, legal, human resources, and finance teams, to ensure alignment of licensing and credentialing activities with organizational goals and objectives
- Serve as a subject matter expert on licensing and credentialing matters, providing guidance and support to internal teams as needed
What You Need to Succeed in the Role
- Bachelor’s degree
- At least 2 years administrative experience, familiarity working in a healthcare startup strongly preferred
- Experience with clinician licensing preferred, specific experience with an emphasis on psychologists, clinical social workers, mental health counselors, and physicians
- Experience with payer enrollment and NCQA-compliant credentialing highly preferred, bonus points if you have used a credentialing platform or CVO previously
- Thorough knowledge of state and federal regulations related to mental health licensure and credentialing
- Very strong attention to detail and outstanding organization skills
- Excellent task management and communication skills, ability to work successfully across diverse teams
- Proactively take ownership of diverse projects and tasks
- Proficient in basic computer skills with a strong ability to learn and adapt to new technologies quickly
The expected annual salary for this role is between $55,000-60,000. Actual starting salary will be determined on an individualized basis and will be based on several factors including but not limited to specific skill set, work experience, etc.
