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Credentialing and Licensing Coordinator
2 months ago
Company Overview:
Quartet is a premier technology-driven behavioral health organization collaborating with health plans, systems, and provider groups to enhance the delivery of quality behavioral health services. Utilizing advanced data analytics and tailored services, Quartet aims to elevate care quality through four key metrics: timely access to care, seamless patient experiences, improved health outcomes, and cost-effectiveness. The organization is supported by prominent venture capital from leading investors.
We are dedicated to fostering a diverse workforce and cultivating an equitable and inclusive environment where all Quartet team members can thrive and contribute meaningfully. This commitment is essential to our mission of enhancing the lives of individuals facing mental health challenges.
Position Summary:
Quartet is in search of a Licensing and Credentialing Specialist to facilitate the licensing and credentialing processes for our clinical staff. Working closely with the care team, this role is vital for scaling patient services and broadening access. The successful candidate will ensure that all healthcare professionals within our organization are appropriately licensed and credentialed in compliance with state regulations and organizational standards. This role demands meticulous attention to detail, a proactive approach to supporting our care team, and exceptional organizational skills.
Key ResponsibilitiesLicensing Duties:
- Assist in the onboarding and licensing of new clinical personnel.
- Oversee the complete lifecycle of licensing applications, ensuring all documentation for clinicians, including nurses, nurse practitioners, social workers, therapists, and physicians, is accurate and complete.
- Manage state license renewals and compact renewals as required.
- Continuously monitor and update licensing records to reflect current status and changes.
- Research and interpret state and federal regulations governing mental health services licensure to remain informed of the latest compliance requirements.
- Develop and maintain an extensive understanding of licensing requirements across various jurisdictions to ensure compliance as the organization expands.
Credentialing Responsibilities:
- Coordinate the initial and ongoing credentialing processes for licensed providers, including the verification of education, training, licensure, and professional experience to meet organizational and regulatory standards.
- Track and manage provider credentialing as new payor contracts are established and as we enter new states.
- Maintain an accurate database of provider credentials, ensuring compliance with organizational policies and relevant regulations.
- Support payor enrollment activities to ensure providers are correctly set up in payor systems.
Documentation and Compliance:
- Keep precise and current records of all licensing, credentialing, and privileging activities, including compliance documentation.
- Conduct regular audits of licensing and credentialing records to identify discrepancies or potential compliance issues.
- Assist in the interpretation, development, and implementation of systems to ensure ongoing compliance with applicable laws and standards.
Collaboration Across Functions:
- Work closely with internal teams, including clinical operations, legal, human resources, and finance, to align licensing and credentialing activities with organizational objectives.
- Act as a subject matter expert on licensing and credentialing, providing guidance to internal teams as necessary.
Delegated Credentialing Oversight:
- Oversee all delegated activities to ensure compliance with CMS and NCQA standards.
- Ensure thorough preparation of documentation and reports for regulatory audits related to delegation oversight.
- Facilitate communication with delegates regarding audits and compliance.
- Implement and maintain a comprehensive delegation oversight program to support credentialing delegation.
Qualifications:
- Bachelor's Degree in a relevant field with a minimum of 4 years of experience.
- 3-5+ years of administrative experience in a healthcare environment is preferred.
- Experience in licensing or credentialing across various provider types is required; specific experience with therapists, nurses, nurse practitioners, and medical doctors is preferred.
- In-depth knowledge of state and federal regulations related to mental health licensure and credentialing.
- Exceptional attention to detail and organizational skills.
- Strong task management and communication abilities, with a capacity to collaborate effectively across diverse teams.
- Proficiency in G-suite tools.
- Familiarity with provider licensure and credentialing software is advantageous.
Benefits:
Quartet offers a comprehensive benefits package, including:
- Fully remote work opportunities.
- Competitive salary structure.
- Unlimited paid time off and paid holidays.
- Paid parental leave.
- Comprehensive medical, dental, and vision insurance plans.
- 401(k) plan with employer matching.
- Mental health benefits through our Employee Assistance Program.
- Employer-paid life insurance and disability coverage.
- Annual budget for learning and development.
Compensation:
The anticipated salary range for this position is $80,000 - $90,000, with an additional 5% annual bonus potential.
Quartet is an equal opportunity employer and encourages applicants from all backgrounds to apply. We do not discriminate based on race, color, ancestry, religion, national origin, sexual orientation, age, citizenship, marital or family status, disability, gender, gender identity or expression, pregnancy or caregiver status, veteran status, or any other legally protected status.
