All roles

[Remote] Credentialing & Licensing Specialist - Healthcare (Remote)

Remote · USA Full-time New today

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

  • 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
  • Maintain accurate and up-to-date credentialing files for company entities, facilities, and assigned clinical or non-clinical personnel
  • Coordinate renewals, updates, revalidations, and filings to ensure zero lapses in provider or organizational status
  • Review payer contracts, state requirements, and program terms to determine applicable credentialing or enrollment obligations
  • Monitor application statuses and proactively follow up with payers or agencies to ensure timely approvals
  • Escalate complex or high-risk items appropriately with recommended next steps
  • Prepare and submit credentialing, licensing, compliance, and operational sections of Requests for Proposals (RFPs) and related bid documents
  • Ensure responses are accurate, aligned with current licensing and enrollment status, and submitted within required deadlines
  • Collaborate with Sales, Compliance, Legal, and Operations teams to ensure RFP responses reflect accurate program capabilities and regulatory standing
  • Maintain and update the credentialing and compliance source content library, including standard narratives, licensing documentation, policies, and required attachments
  • Ensure version control and document accuracy across shared platforms (e.g., Salesforce, SharePoint, proposal libraries)
  • Regularly validate that stored documentation reflects current regulatory status and organizational capabilities
  • Identify outdated or inconsistent materials and proactively update to maintain audit readiness and proposal accuracy
  • Partner with Compliance, HR, Operations, Sales, and Legal teams to ensure credentialing and RFP requirements align with workforce onboarding, contract execution, and implementation timelines
  • Respond to stakeholder inquiries within established service standards
  • Participate in implementation planning for new states, markets, payer contracts, and RFP opportunities
  • Communicate timelines, risks, and dependencies clearly and professionally
  • Maintain accurate records in Salesforce, SharePoint, credentialing platforms, RFP systems, and applicable payer portals Skills
  • 2+ years of experience in healthcare credentialing, provider enrollment, licensing, compliance, or RFP coordination required
  • Proficiency in Microsoft Office Suite, Salesforce, Adobe Acrobat, credentialing platforms/portals, and document management systems
  • Bachelor's degree preferred or equivalent professional experience
  • Working knowledge of Medicaid, Medicare Advantage, MCO, and state Medicaid credentialing processes preferred
  • Experience contributing to RFP preparation or maintaining proposal documentation strongly preferred Company Overview
  • 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 Apply To This Job Apply tot his job Apply To this Job

Apply To This Job

Related roles

Medical Insurance Credentialing Specialist Full-Time

Remote · USA Full-time

Licensing and Credentialing Specialist- North Carolina

Remote · USA Full-time

[Hiring] Medical Staff Credentialing Specialist @MPOWERHealth

Remote · USA Full-time

Insurance Verifier Representative I

Remote · USA Full-time

[Remote] Remote Insurance Verification Specialist, Specialty (Florida)

Remote · USA Full-time

[Remote/WFM] $17hr *FULLY REMOTE* Medical Insurance Verification

Remote · USA Full-time

HEDIS Review Nurse - Remote - Contract

Remote · USA Full-time

HEDIS Review Nurse - Remote - Contract

Remote · USA Full-time

[Remote] Senior Abstractor, HEDIS/Quality Improvement (Remote)

Remote · USA Full-time

Abstractor, National HEDIS /Quality Improvement (Remote)

Remote · USA Full-time

Founding Software Engineer - Agentic AI (Remote)

Remote · USA Full-time

Senior Software Engineer, Core Experiences - Lexington, KY, USA

Remote · USA Full-time

[Remote] B2B Marketing Consultant (Job ID: STASAM1R)

Remote · USA Full-time

Entry Level Work From Home Remote Position Focus Group Panelist

Remote · USA Full-time

Manager of Program and Partnerships, Energy Transition Network

Remote · USA Full-time

Remote Event Manager

Remote · USA Full-time

Experienced Part-Time Data Entry Clerk – Flexible Schedule and World-Class Team

Remote · USA Full-time

Software Developer/Engineer (DoD Skillbridge)

Remote · USA Full-time

[Remote] Sales Recruiter

Remote · USA Full-time

(Remote) - Entry-Level Account Manager (20 - 27 per hour)

Remote · USA Full-time