Licensing and Credentialing Specialist

Connecting for Better Health

Licensing and Credentialing Specialist at Oshi Health managing payer enrollment and compliance. Collaborating with operational teams to ensure providers are credentialed and ready to deliver care.

Posted 7/15/2026full-timeRemote • Arizona, Florida, Idaho, Louisiana, Montana, New Hampshire, North Carolina, South Carolina, Tennessee, Texas, Vermont, Virginia • 🇺🇸 United StatesMid-LevelSenior💰 $65,000 - $75,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing the end-to-end payer enrollment process, ensuring compliance with NCQA, CMS, and state requirements while maintaining accurate provider data across various platforms. Proficient in collaborating with cross-functional teams to enhance enrollment workflows and support provider licensing activities.

Highest-signal resume keywords

Payer Enrollment ManagementProvider CredentialingCAQH KnowledgeNCQA ComplianceGoogle Workspace Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer EnrollmentCredentialingProvider Roster ManagementAudit PreparationMulti-State Provider Management

Soft Skills

Organizational SkillsAttention to DetailWritten CommunicationVerbal Communication

Tools & Technologies

Payer PortalsCredentialing SystemsGoogle Sheets

Industry Keywords

MedicareMedicaidHealthcare AdministrationLicensingCompliance Requirements

About the role

Key responsibilities & impact

Own the end-to-end payer enrollment process for new and existing providers, including initial enrollments, revalidations, demographic updates, terminations, and maintenance across commercial, Medicare, and Medicaid health plans.
Submit, track, and proactively follow up on payer enrollment applications to ensure timely provider participation and minimize delays to patient care and revenue.
Serve as the primary point of contact with national and local health plans, delegated credentialing organizations, CVOs, and internal stakeholders to resolve enrollment issues, missing information requests, and payer escalations.
Maintain accurate provider data across payer portals, CAQH, credentialing systems, and internal tracking tools, ensuring consistency across all platforms.
Support delegated credentialing activities by maintaining provider rosters, submitting required updates, monitoring compliance requirements, and preparing documentation for internal and external audits.
Conduct routine audits of provider enrollment and credentialing files to ensure compliance with NCQA, CMS, state, and payer-specific requirements.
Monitor key enrollment and credentialing metrics, identify risks to provider participation, and communicate status updates and timelines to leadership and cross-functional partners.
Collaborate closely with Licensing, Practice Operations, Revenue Cycle, Recruiting, and Clinical Operations teams to ensure providers are fully credentialed, enrolled, and ready to see patients on schedule.
Identify opportunities to improve enrollment and credentialing workflows through process standardization, documentation, automation, and operational efficiencies.
Support provider licensing activities as needed, including coordinating new state license applications, renewals, cross-licensure efforts, and maintaining accurate licensure records.
Monitor provider licenses, DEA and CDS registrations, board certifications, malpractice coverage, and other required credentials to ensure continuous compliance.
Provide exceptional support to providers throughout the enrollment, credentialing, and licensing process by communicating requirements, timelines, and next steps clearly and proactively.

Requirements

What you’ll need

Bachelor’s Degree in Healthcare administration or related field
3+ years of experience in provider payer enrollment and credentialing
Experience managing provider enrollments with commercial, Medicare, and Medicaid payers.
Experience supporting delegated credentialing activities, including provider rosters, ongoing monitoring, or audit preparation.
Experience with multi-state or national provider organizations.
Working knowledge of CAQH, payer portals, and provider credentialing systems.
Understanding of NCQA, CMS, state licensing, and payer credentialing requirements.
Strong organizational skills with the ability to manage multiple priorities and deadlines.
Excellent attention to detail and written and verbal communication skills.
Proficiency with Google Workspace, including Google Sheets.

Benefits

Comp & perks

Employer-sponsored medical, dental, and vision coverage
Unlimited PTO + 11 paid company holidays
Eligibility to contribute to 401(k)
Tailored professional development opportunities as we scale
Access to Overalls, because we know life happens