CirrusMD is a text-first enterprise solution that connects people and doctors with no-barriers access to human experts who can always help. CirrusMD was founded in 2012 and is headquartered in Denver, CO. We have partnered with over a dozen major national payers and healthcare systems to deliver extraordinary virtual care to millions of lives across the nation. If you are looking to make a lasting impact where your voice matters, consider joining our team.

Who We’re Looking For:

We are looking for an experienced Licensing & Credentialing Supervisor to join our team to contribute to our mission of redefining the healthcare experience for patients and providers. Under limited supervision, the Licensing and Credentialing Supervisor will supervise the CirrusMD Provider Network’s (CMDPN) licensing and credentialing functions and assigned team. This position reports to the Director of Clinical Operations. The salary range for this position is $52,000-62,000 depending on experience.

What You’ll Accomplish:

This role will oversee development, management and monitoring processes and procedures that support the initial application and renewals of state medical licensing, insurance plan enrollments, and internal credentialing including delegated credentialing contract processes. The Licensing and Credentialing Supervisor will ensure compliance with the appropriate accrediting and regulatory agencies. and supervise staff in the day-to-day management of the overall CMDPN licensing and credentialing process and database management.

Licensing

• Manage the CMDPN licensing process for all CirrusMD clinical providers, in accordance with Federal and State laws, and CirrusMD policies.
• Coordinate the management of the licensing database, ensuring accuracy of data and reporting to partnering systems. Monitors critical data for extensive analysis and report generation.
• Coordinate the oversight of CMDPN contractors hired to support the licensing application process.
• Work closely with physicians to successfully gather necessary information and forms for State Medical applications.
• Complete applications through to submission and approval for any work not assigned externally.
• Monitor the expirables process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
• Monitor and report turnaround times of Medical licensing approval across all 50 states.
• Manage licensing procedures; develop, recommend, and/or implement changes, revisions, and enhancements as appropriate to current operating environment.
• Track and report on annual CME earned by the providers.

Credentialing

• Manage the CMDPN credentialing process for all CirrusMD clinical providers, in accordance with NCQA, Delegated contracts and CMS accreditation standards, Federal and State laws, and CirrusMD policies.
• Coordinate the management of the credentialing database, ensuring accuracy of data and reporting to partnering systems. Monitors critical data for extensive analysis and report generation.
• Coordinate the management of CMDPN credentialing applications, to ensure distribution, receipt, processing, and timely management through our credentialing process.
• Coordinate the management of the expirables process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
• Monitor and report turnaround times for processing of credentials applications, with continued focus on delivery of a high quality product, with the greatest efficiency, in the least amount of time, and in accordance to CMDPN policy timelines.
• Manage Credentialing policies and procedures; develops, recommends, and/or implements changes, revisions, and enhancements as appropriate to current operating environment.
• Provide consultations with regards to credentialing practices and services; prepares and conducts credentialing orientations and provides updates as appropriate on new policies and procedures.
• Analyze NCQA, delegation contract, state laws and CMS standards and develops criteria to ensure compliance; revises general aspects of credentialing and privileging process as necessary; makes recommendations for and implements changes in policies and procedures.
• Prepare for and coordinate credentialing audits in compliance with the managed care delegated credentialing contracts and accreditation bodies.
• Function as primary CMDPN credentials contact for all internal and external inquiries; develops and maintains positive working relationships.
• Represent CMDPN to internal and external customers as appropriate; makes presentations to and interacts with various internal and external customers on issues pertinent to area of specialty.
• Maintain the CMPND Provider Directory. Keeps all necessary parties updated with changes to the Network provider list and field any inquiries regarding provider CMDPN credentialing.
• Performs miscellaneous job-related duties as assigned.

Requirements

• 3-5 years of experience in licensing and credentialing preferred
• Preference for earned bachelor’s degree and/or at least 5 years of experience directly related to the duties and responsibilities specified.
• Certification/Licensure NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS) or actively pursuing certification is preferred.
• Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis

What Will Make You Stand Out:

• Ability to make administrative/procedural decisions and judgments.
• Ability to work independently; seeking help as necessary
• Ability to investigate and analyze information and draw conclusions.
• Ability to develop and deliver presentations.
• Ability to process computer data and to format and generate reports.
• Ability to communicate effectively, both orally and in writing.
• Ability to foster a cooperative work environment.
• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
• Skill in developing policy and procedure documentation.
• Database management skills.
• Employee development and performance management skills.
• Knowledge of related accreditation and certification requirements.
• Knowledge of medical credentialing and privileging procedures and standards.
• Knowledge of medical staff policies, regulations, and bylaws and the legal environment within which they operate.
• Prior experience with budget preparation.

Benefits

Who We Are:

Based in Denver, CirrusMD is the nation's leading virtual care platform, delivers a chat first, multi-modal, data driven platform to enable providers, payers and employers the ability to offer high touch, personalized healthcare to their members or employees. Founded in 2012, CirrusMD helps health plans create happier, healthier, and more engaged members by giving them access to on-demand virtual care solutions that they love to engage with. Our chat-powered care delivery platform connects members to a dedicated, board-certified physician in under 90 seconds from any web-enabled device, with no cost and no time limits attached. CirrusMD enables a stress-free, human care conversation that doesn’t end until members get the answers (and peace of mind) they need to manage their wellness.

Why Work at CirrusMD?

CirrusMD is quickly transitioning from a startup to a highly recognized healthcare industry disruptor. If you are looking to make a lasting impact where your voice matters, consider joining our team and help us deliver Care Without Barriers. We offer an exceptional benefits package including health, dental and vision, 401k savings, flexible vacation and remote work policies, competitive salaries, stock options and more.

CirrusMD is committed to creating a diverse and inclusive workforce and is proud to be an equal opportunity employer. We aim to create a workplace that celebrates the diversity of our employees, users, and customers. We strive to deliver products and services that work for everyone by including perspectives from backgrounds that vary by race, ethnicity, social background, religion, gender, age, disability, sexual orientation, veteran status, and national origin. We are particularly focused on ensuring women and BIPOC are equally represented across all positions, including management. Our focus is on advancing, cultivating, preserving a culture of diversity and inclusion as it directly aligns with our mission to provide access to affordable and personalized health care for everyone.

*Only candidates who are eligible to work for all US employers and not only their current employer will be considered.

Notice to recruiters and placement agencies:

If you are a recruiter or placement agency, please do not submit résumés to any person or email address at CirrusMD prior to having a signed agreement with Human Resources. CirrusMD is not liable for and will not pay placement fees for candidates submitted by any agency other than its approved recruitment partners. Also, any résumés sent to us without an agreement in place will be considered your company's gift to CirrusMD and may be forwarded to our Talent Acquisition team.