Compliance Manager

Provider Enrollment, Licensing & Credentialing Specialist
Schedule:
• Monday to Friday
• 8:00 AM – 6:00 PM (EST)
Responsibilities:
• Manage end-to-end state licensing, credentialing, Medicaid and Medicare enrollment, insurance applications, and regulatory documentation for home care, home health, and hospice agencies.
• Supervise the execution and administration of all Provider Enrollment contracts.
• Support Sales team with commercial calls, contract review and issuance.
• Address and resolve client inquiries, complaints, investigations, and clarifications.
• Act as Application Traffic Coordinator.
• Prepare and oversee monthly reports including Financial Liability Report, Application Tracker, and Submission/Approval Reports.
• Handle state-specific issues with Ombudsman Offices and State Supervisors/Directors.
• Draft and update Medicaid Waiver application policies and procedures.
• Conduct state and program regulatory research to support internal teams and sales.
• Review and prepare Corrective Action Plans and required state authority documentation.
• Complete licensing, credentialing, and provider enrollment applications fully.
• Process documentation accurately on state and agency portals.
• Communicate with clients to gather required documentation per state.
• Stay updated on state regulations and insurance program requirements.
• Maintain application documentation, requirements, and status in CRM and trackers.
• Review applications to ensure completeness and accuracy before submission.
• Educate clients on timelines, requirements, and expectations throughout processes.
• Prioritize and manage incoming customer calls.
• Enter new contracts into CRM (Nutshell).
• Scan, upload, and organize client documents on Shared Drive.
• Create, audit, and correct monthly reports.
• Process application cancellations and termination agreements.
• Manage emails and reception tasks.
• Provide support with copying, faxing, mailing, and internal meetings.
Education & Experie...