.jpg?1741786664)
Team Lead, Licensing and Credentialing
About the Role
The Licensing & Credentialing (L&C) Lead plays a pivotal role in ensuring Ophelia’s clinicians are fully licensed, credentialed, and enrolled across multiple states and payors enabling timely patient access and operational excellence.
This is a player/coach role: you will handle complex L&C cases while also supporting, mentoring, and providing daily oversight to L&C Specialists. You’ll influence process improvements, serve as the SME for internal partners, and help uphold a high-performing, compliant, and patient-centered L&C team.
If you are detail-oriented, collaborative, and excited to support and elevate others while driving results, this is a great opportunity to contribute to a critical function at Ophelia.
Key Responsibilities
- Execute licensing, credentialing, and enrollment processes across assigned markets with accuracy, timeliness, and compliance.
- Serve as the primary escalation point for complex or at-risk applications, troubleshooting issues and supporting providers and Specialists.
- Mentor, train, and guide L&C Specialists, providing daily oversight, quality checks, and workload support.
- Maintain accurate documentation, updates, and audit-ready records across all credentialing and workflow systems.
- Identify workflow gaps and recommend improvements to enhance efficiency, accuracy, and scalability of L&C operations.
- Serve as the L&C SME with external partners, including payors, Medicaid agencies, and licensing boards, to reduce delays and resolve escalations.
- Collaborate cross-functionally (Billing and Clinical Ops) to resolve issues, clarify requirements, and drive alignment.
- Support SOP updates, audits, and implementation of new processes as NCQA, CMS, state, and payor requirements evolve.
Qualifications
- 5+ years previous experience in licensing, credentialing, or provider enrollment within a healthcare or behavioral health setting across multiple states.
- Experience leading or mentoring others within the licensing and credentialing environment.
- National Association of Medical Staff Services (NAMSS) Certified Provider Credentialing Specialist (CPCS) certification
- Strong knowledge of NCQA, CMS/Medicare, CAQH, Medicaid, and multi-state licensing/credentialing regulations.
- Proficiency with credentialing systems, workflow tools, and productivity platforms (ClickUp, Slack, MS/Google Suite).
- Ability to build strong relationships and communicate clearly across internal and external teams.
- High degree of professionalism, confidentiality, and accountability.
Our Benefits Include:
- Remote work anywhere in the United States
- Competitive medical, vision, and health insurance (many plans are fully covered for the employee!)
- 20 days of PTO per year
- 10 company holidays
- 401k Contribution Platform
- Additional benefits offered through our benefits provider such as life insurance, short and long term disability, financial wellness, virtual primary care, among others!
#LI-Remote
- We set compensation based on the level and skills required for the role. We value pay transparency and equity, and are committed to fair pay. In order to prevent pay disparities and reduce time spent in negotiations, we take a “first and best” offer approach: this means we’re not holding any compensation back from our candidates, and you can feel confident that our pay is fair and does not vary based on the strength of someone’s negotiation skills.
- Compensation is dynamic at Ophelia: as long as the company performs well and meets our targets, there will be opportunities for increased compensation annually. We’re happy to discuss this approach and our bands if you have questions during the interview process.
Compensation Range
$85,000 - $95,000 USD
Interested in learning more about Ophelia and this role? Apply to work with us!
Create a Job Alert
Interested in building your career at Ophelia? Get future opportunities sent straight to your email.
Apply for this job
*
indicates a required field