[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
- 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- Identify outdated or inconsistent materials and proactively update to maintain audit readiness and proposal accuracy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 To this Job