Credentialing Licensing and Eligibility Manager

Licensing, Credentialing & Eligibility ManagerLocation: In OfficeEmployment Type: Full-TimeCompany: Dr. MobiCareAbout the RoleDr. MobiCare is seeking an experienced Licensing, Credentialing & Eligibility Manager to lead all provider credentialing, licensing, and payer enrollment efforts across multiple states and clinical settings. This role ensures that all providers remain fully compliant, accurately credentialed, and seamlessly enrolled with payers to support uninterrupted patient care.The ideal candidate is highly organized, detail-oriented, and skilled at navigating regulatory requirements, payer processes, and multi-state licensing workflows.Key ResponsibilitiesLicensing & Credentialing ManagementOversee and manage all provider licensing, renewals, and credentials across states and partner facilities.Ensure accuracy, completeness, and compliance of provider files, certifications, and documentation.Maintain up-to-date records in internal systems and monitor upcoming expirations.Payer Enrollment & Eligibility OversightManage all payer enrollment workflows, including Medicare, Medicaid, and commercial plans.Ensure timely submission of applications and follow-up to prevent delays in reimbursement.Oversee eligibility verification processes to reduce claim denials and enrollment-related errors.Compliance & Quality AssuranceEnsure compliance with regulatory, facility, and payer requirements.Develop and maintain standard operating procedures (SOPs) for credentialing and enrollment.Conduct periodic audits to verify documentation accuracy, credentialing status, and workflow efficiency.Team Leadership & CollaborationCoordinate closely with Revenue Cycle, HR, Clinical Operations, and Compliance teams.Serve as the organizational subject-matter expert on credentialing, licensing, and enrollment requirements.Provide training, tools, and guidance to internal staff on credentialing and eligibility processes.Process ImprovementIdentify bottlenecks and implement streamlined workflows to improve turnaround times.Monitor regulatory changes and payer updates; communicate relevant changes to leadership.Ensure proactive management of renewals and high-risk expiration timelines.QualificationsRequired3 years of experience in provider credentialing, licensing management, or payer enrollment.Strong understanding of credentialing standards, payer enrollment processes, and healthcare compliance.Experience working with Medicare/Medicaid and commercial insurance plans.High attention to detail, organization, and accuracy.Excellent communication and problem-solving skills.PreferredExperience in a multi-state healthcare organization or specialty practice.Prior leadership or team management experience.Familiarity with credentialing software (e.g., CAQH, PECOS) and payer portals.Knowledge of Revenue Cycle workflows and eligibility systems.

Salary : $28 - $32