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 & Experience:
• High school diploma or GED.
• 1 to 2 years of experience in licensing, credentialing, provider enrollment, compliance, or legal research.
• Experience in home care, home health, or hospice sectors.
• Proven ability to manage high volume caseloads and meet deadlines.
• Knowledge of regulatory research or state compliance is a plus.
Technical Skills:
• Proficient with Microsoft 365 and Microsoft Office.
• Intermediate Adobe Acrobat skills.
• Experience with CRM systems (Nutshell preferred; Salesforce desirable).
• Strong research skills in state government portals.
• Ability to quickly learn new systems and workflows.
• Experience documenting processes and maintaining detailed trackers.
Soft Skills:
• High attention to detail and organizational skills.
• Excellent written and verbal communication in English.
• Customer service oriented with professional demeanor.
• Ability to interpret complex regulations and guidelines.
• Logical thinking and strong problem-solving skills.
• Ability to work independently and collaboratively.
• Resilience in fast-paced, high-volume environments.

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