Job description
Under the direction of the Program Manager, the Lead Provider Licensing Specialist at Blue Circle Health is a fully remote, full-time position vital to ensuring compliance with national regulatory standards. This role is responsible for managing provider licensing across all 50 U.S. states for employed providers and overseeing provider licensing, regulatory compliance, and collaboration agreement processes to ensure compliance with state and federal requirements. With a focus on innovation and efficiency, the role drives our expansion efforts while safeguarding compliance standards in a fast-paced, mission-driven environment.The Lead Provider Licensing Specialist serves as a subject-matter expert and day-to-day leader within the Provider Licensing Team, providing guidance, troubleshooting complex issues, improving processes, and helping ensure work is completed accurately and efficiently. This role provides day-to-day guidance, coaching, and feedback to our Provider Enrollment Specialist while partnering with our Program Manager on formal performance and people-related matters.
Ideal candidates bring startup experience, a strong understanding of healthcare regulations, and a passion for solving complex challenges. They are detail-oriented, thrive in collaborative environments, and excel in managing critical processes to make a meaningful impact.
This is a full time, remote, home-office based role eligible for a full benefits package including paid holidays, PTO, and competitive pay in a mission-based work environment. A private, quiet, home office space is required.
This role is open to candidates residing anywhere in the United States who are legally authorized to work in the U.S. on a full-time basis, now and in the future, without employer sponsorship.
Job requirements
- Minimum of 5 years of progressively responsible experience in provider licensing, credentialing, healthcare regulatory compliance, or a related field.
- Experience overseeing multi-state licensing activities.
- Minimum of 2 years of experience providing day-to-day leadership and guidance, to others, providing feedback, and supporting performance and development.
- Startup or experience with national multi-state healthcare organizations is ideal; non-profit experience a plus.
- Deep understanding of licensing board standards and government procedures.
- Ability to gather, analyze, and evaluate information for accurate decision-making.
- Proficiency in identifying and implementing solutions to streamline processes.
- Strong capability to maintain accurate and well-organized records. Keen attention to detail to ensure compliance and prevent discrepancies.
- Excellent written and verbal communication skills to interact effectively with internal and external stakeholders. Collaborative mindset to work with diverse teams and external agencies.
- High degree of independence to manage responsibilities and make sound decisions with the ability to discern when to escalate issues to management.
- Flexibility to adapt to changing regulatory environments and organizational priorities.
- Must maintain a high level of confidentiality at all times.
- Familiarity with payer credentialing and regulatory compliance.
- Ability to support provider enrollment activities for Medicare, Medicaid, and payor credentialing activities as needed and provide backup coverage for the Provider Enrollment Specialist.
- Demonstrated ability to interpret requirements, troubleshoot complex issues, and exercise sound judgment with limited direction.
Job responsibilities
- Handle initial licensing applications and renewals for healthcare providers such as physicians, nurse practitioners, licensed clinical social workers, and registered dietitians.
- Ensure provider licensing policies and procedures are efficient and compliant with State Medical Licensing Board regulations.
- Collect, analyze, and evaluate provider-specific information to meet licensing board requirements.
- Coordinate, maintain, and monitor provider collaborative agreements and related regulatory documentation across applicable states. Ensure agreements are established, renewed, and maintained in accordance with state-specific requirements, organizational policies, and applicable licensing board regulations, while supporting ongoing provider compliance and audit readiness.
- Stay updated on evolving regulations, standards, and procedures to maintain compliance with national regulatory standards.
- Maintain effective communication with internal teams, including providers, clinical staff, IT, administration, and finance departments.
- Collaborate externally with licensing vendors, licensing boards, credentialing departments, and government agencies (e.g., CMS).
- Maintain organized and up-to-date provider files as official records and ensure accuracy in the event of discrepancies.
- Identify opportunities for performance improvement in the licensing process; recommend and implement strategies to enhance operational efficiency.
- Monitor unresolved issues, provide regular updates through reporting, and escalate matters to management as needed.
- Serve as a subject-matter expert and go-to resource for provider licensing and credentialing questions.
- Provide day-to-day guidance, coaching, and support to our Provider Enrollment Specialist on processes, priorities, and complex cases.
- Help onboard and train new team members and contribute to ongoing team learning.
- Review work for accuracy and completeness and provide constructive feedback when appropriate.
- Help identify workflow challenges, recommend solutions, and support consistent practices across the team.
- Escalate performance or employee relations concerns to the Program Manager rather than independently managing formal performance processes.
Job benefits
Compensation:$35-$40/hour. This range reflects the good faith estimate of the compensation we reasonably expect to pay for this position. Individual compensation decisions are based on job related factors, including skills, experience and internal equity.
Benefits:
- Health + dental + vision + short & long term disability coverage.
- 401(k)
- PTO & Holidays
- Opportunity to shape a healthcare delivery system and contribute to strategy every step of the way.
- Make an impact in the lives of patients at a non-profit dedicated to improving healthcare.
We are an equal opportunity employer and do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
5+ years in provider licensing/credentialing/healthcare compliance; 2+ years leading others; multi-state licensing experience; strong regulatory knowledge; U.S. work authorization without sponsorship; home office required.
Key Responsibilities
- managing provider licensing
- ensuring regulatory compliance
- coordinating collaboration agreements
Job Details
- Category: Healthcare Services - Allied Health
- Seniority: Senior Level
- Commitment: Full Time
- Workplace: Remote — United States
- Salary: USD 72,800 – 83,200 / year
- Languages: English
Benefits
- Generous paid time off
- Retirement plan
About Blue Circle Health
A non-profit healthcare organization dedicated to improving healthcare and ensuring regulatory compliance. — Industry: Healthcare