Credentialing and Licensing Specialist

Credentialing and Licensing Specialist 

Location: Remote 

Reports to: Director of Operations 

Employment Type: Full-time, W2

About FamilyWell Health: 

FamilyWell Health is a tech-enabled behavioral health company dedicated to solving the women’s mental health crisis by seamlessly embedding high quality, equitable, & affordable mental health care into OB/Gyn clinics. Founded by a physician mother and led by women, FamilyWell integrates comprehensive women’s mental health programs into Ob/Gyn practices utilizing the collaborative care model. For more information, visit familywellhealth.com.

Position Overview: 

FamilyWell Health is seeking a detail-oriented and proactive Credentialing and Licensing Specialist to join our Operations team. This role is vital to ensuring our clinical team members are fully credentialed, licensed, and compliant with federal, state, and payer-specific regulations. The ideal candidate will have experience in healthcare credentialing, licensing, and provider enrollment with commercial and Medicaid/Medicare plans. 

Key Responsibilities: 

Credentialing & Re-credentialing 

• Prepare and submit credentialing and re-credentialing applications for all clinical providers (e.g., therapists, psychiatric providers). 
• Maintain up-to-date credentialing records in internal databases and credentialing software (e.g., CAQH, NPPES). 
• Manage expirables such as licensure, DEA, board certifications, and malpractice insurance. 

Licensing 

• Coordinate initial and renewal licensure processes for providers across multiple states.
• Track state-specific licensure requirements and ensure timely completion of all applications. 
• Communicate directly with state licensing boards, as needed, to facilitate resolutions. 

Payer Enrollment 

• Enroll providers with commercial and Medicaid/Medicare payers in applicable markets. 
• Monitor application statuses and follow up with payers to resolve delays or denials. 
• Support enrollment into Collaborative Care billing programs where applicable. 

Compliance & Documentation 

• Maintain compliance with NCQA, CMS, state, and payer standards. 
• Develop and maintain credentialing policies and procedures to align with organizational and regulatory standards. 
• Create and manage tracking systems for credentialing, licensing, and payer enrollment milestones. 

Cross-functional Collaboration 

• Partner with Clinical, Operations, and Revenue Cycle teams to ensure timely onboarding and billing readiness of providers. 
• Communicate status updates and potential risks or delays clearly and proactively.

Qualifications: 

Required: 

• 2+ years of experience in credentialing, licensing, or payer enrollment in a healthcare setting. 
• Strong knowledge of CAQH, NPPES, PECOS, and Medicaid/Medicare systems. 
• Familiarity with behavioral health and telehealth provider credentialing. 
• Exceptional attention to detail, organizational, and project management skills. 
• Ability to work independently in a fast-paced, multi-state environment. 
• Strong written and verbal communication skills. 

Preferred: 

• Experience with Collaborative Care Model billing or perinatal mental health services. 
• Knowledge of payer enrollment processes in states like Massachusetts, New York, North Carolina, or Texas. 
• Familiarity with credentialing software tools. 

Compensation & Benefits: 

• Competitive salary, commensurate with experience. 
• Health, dental, and vision insurance. 
• Flexible remote work policy. 
• Generous PTO and parental leave. 
• Mission-driven team with a collaborative culture and clear impact.