[Remote] Credentialing & Licensing Specialist - Healthcare (Remote)
Note: The job is a remote job and is open to candidates in USA. Connect America is the largest independent provider of connected care in North America, dedicated to helping aging individuals and at-risk populations live safely and independently. The Credentialing & Licensing Specialist is responsible for executing credentialing, enrollment, licensing, and RFP submission activities, ensuring compliance and timely submissions across various service lines.
Responsibilities
ā¢ Prepare, submit, track, and follow up on credentialing and enrollment applications for Medicaid agencies, MCOs, IDNs, Medicare Advantage plans, and other commercial or government payers
ā¢ Maintain accurate and up-to-date credentialing files for company entities, facilities, and assigned clinical or non-clinical personnel
ā¢ Coordinate renewals, updates, revalidations, and filings to ensure zero lapses in provider or organizational status
ā¢ Review payer contracts, state requirements, and program terms to determine applicable credentialing or enrollment obligations
ā¢ Monitor application statuses and proactively follow up with payers or agencies to ensure timely approvals
ā¢ Escalate complex or high-risk items appropriately with recommended next steps
ā¢ Prepare and submit credentialing, licensing, compliance, and operational sections of Requests for Proposals (RFPs) and related bid documents
ā¢ Ensure responses are accurate, aligned with current licensing and enrollment status, and submitted within required deadlines
ā¢ Collaborate with Sales, Compliance, Legal, and Operations teams to ensure RFP responses reflect accurate program capabilities and regulatory standing
ā¢ Maintain and update the credentialing and compliance source content library, including standard narratives, licensing documentation, policies, and required attachments
ā¢ Ensure version control and document accuracy across shared platforms (e.g., Salesforce, SharePoint, proposal libraries)
ā¢ Regularly validate that stored documentation reflects current regulatory status and organizational capabilities
ā¢ Identify outdated or inconsistent materials and proactively update to maintain audit readiness and proposal accuracy
ā¢ Partner with Compliance, HR, Operations, Sales, and Legal teams to ensure credentialing and RFP requirements align with workforce onboarding, contract execution, and implementation timelines
ā¢ Respond to stakeholder inquiries within established service standards
ā¢ Participate in implementation planning for new states, markets, payer contracts, and RFP opportunities
ā¢ Communicate timelines, risks, and dependencies clearly and professionally
ā¢ Maintain accurate records in Salesforce, SharePoint, credentialing platforms, RFP systems, and applicable payer portals
Skills
ā¢ 2+ years of experience in healthcare credentialing, provider enrollment, licensing, compliance, or RFP coordination required
ā¢ Proficiency in Microsoft Office Suite, Salesforce, Adobe Acrobat, credentialing platforms/portals, and document management systems
ā¢ Bachelor's degree preferred or equivalent professional experience
ā¢ Working knowledge of Medicaid, Medicare Advantage, MCO, and state Medicaid credentialing processes preferred
ā¢ Experience contributing to RFP preparation or maintaining proposal documentation strongly preferred
Company Overview
ā¢ Connect America is a PA-based provider of life-saving personal emergency response monitoring services. It was founded in 2004, and is headquartered in Broomall, Pennsylvania, USA, with a workforce of 501-1000 employees. Its website is http://www.connectamerica.com.
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Responsibilities
ā¢ Prepare, submit, track, and follow up on credentialing and enrollment applications for Medicaid agencies, MCOs, IDNs, Medicare Advantage plans, and other commercial or government payers
ā¢ Maintain accurate and up-to-date credentialing files for company entities, facilities, and assigned clinical or non-clinical personnel
ā¢ Coordinate renewals, updates, revalidations, and filings to ensure zero lapses in provider or organizational status
ā¢ Review payer contracts, state requirements, and program terms to determine applicable credentialing or enrollment obligations
ā¢ Monitor application statuses and proactively follow up with payers or agencies to ensure timely approvals
ā¢ Escalate complex or high-risk items appropriately with recommended next steps
ā¢ Prepare and submit credentialing, licensing, compliance, and operational sections of Requests for Proposals (RFPs) and related bid documents
ā¢ Ensure responses are accurate, aligned with current licensing and enrollment status, and submitted within required deadlines
ā¢ Collaborate with Sales, Compliance, Legal, and Operations teams to ensure RFP responses reflect accurate program capabilities and regulatory standing
ā¢ Maintain and update the credentialing and compliance source content library, including standard narratives, licensing documentation, policies, and required attachments
ā¢ Ensure version control and document accuracy across shared platforms (e.g., Salesforce, SharePoint, proposal libraries)
ā¢ Regularly validate that stored documentation reflects current regulatory status and organizational capabilities
ā¢ Identify outdated or inconsistent materials and proactively update to maintain audit readiness and proposal accuracy
ā¢ Partner with Compliance, HR, Operations, Sales, and Legal teams to ensure credentialing and RFP requirements align with workforce onboarding, contract execution, and implementation timelines
ā¢ Respond to stakeholder inquiries within established service standards
ā¢ Participate in implementation planning for new states, markets, payer contracts, and RFP opportunities
ā¢ Communicate timelines, risks, and dependencies clearly and professionally
ā¢ Maintain accurate records in Salesforce, SharePoint, credentialing platforms, RFP systems, and applicable payer portals
Skills
ā¢ 2+ years of experience in healthcare credentialing, provider enrollment, licensing, compliance, or RFP coordination required
ā¢ Proficiency in Microsoft Office Suite, Salesforce, Adobe Acrobat, credentialing platforms/portals, and document management systems
ā¢ Bachelor's degree preferred or equivalent professional experience
ā¢ Working knowledge of Medicaid, Medicare Advantage, MCO, and state Medicaid credentialing processes preferred
ā¢ Experience contributing to RFP preparation or maintaining proposal documentation strongly preferred
Company Overview
ā¢ Connect America is a PA-based provider of life-saving personal emergency response monitoring services. It was founded in 2004, and is headquartered in Broomall, Pennsylvania, USA, with a workforce of 501-1000 employees. Its website is http://www.connectamerica.com.
Apply tot his job
Apply To this Job