Provider Enrollment Specialist

Job Summary

Seeking a hands-on Provider Enrollment & Credentialing Specialist, the full-time position will manage provider licensing, credentialing, and enrollment processes for a multi-state virtual clinical network while ensuring compliance with NCQA standards remotely.

Key responsibilities

• Own end-to-end execution of provider licensing, renewals, re-credentialing, and payer enrollment across all states
• Drive clinician outreach for outstanding documentation and maintain communication with Clinical Operations and People teams regarding provider readiness
• Translate NCQA credentialing standards into workflows and maintain audit-ready documentation year-round

Required qualifications

• 3+ years of hands-on credentialing, provider enrollment, or medical staff services experience in a multi-provider environment
• NCQA credentialing and re-credentialing experience applied in day-to-day operations
• Experience managing multi-state licensure and compliance monitoring
• Fluency with credentialing documentation and primary-source verification processes
• Proven ability to manage high-volume, deadline-driven work with effective communication skills