Credentialing & Licensing Specialist - Healthcare (Remote)

Connect America

2d•Remote

About The Position

Connect America and our family of brands, including Lifeline, have helped aging individuals and at-risk populations live safely and independently in their homes for more than 40 years. As North America’s largest independent provider of connected care, we deliver a growing portfolio of innovative technologies that help bridge the gap between healthcare providers, individuals, and their care partners. Our easy-to-use solutions support health and safety in a way that leads to enhanced quality of life, earlier interventions, reduced hospitalizations, and peace of mind for an estimated 10 million lives every year. Together, we are enabling independence and redefining the global home healthcare market.  Our headquarters are located close to the city of Philadelphia, in Bala Cynwyd, PA. Learn more at www.connectamerica.com [http://www.connectamerica.com/]. Job Overview: Reporting to the Director of Credentialing, the Credentialing Specialist is responsible for executing day-to-day credentialing, enrollment, licensing, and RFP submission activities across PERS, RPM, and telehealth/triage service lines. This role ensures timely, accurate, and compliant submission of provider and organizational applications, renewals, regulatory filings, and credentialing-related RFP responses. The Credentialing Specialist applies professional judgment in interpreting payer, regulatory, and RFP requirements; proactively manages renewal and submission timelines to prevent lapses; and collaborates across internal teams to support program launches, contract obligations, and revenue-generating opportunities. This salaried role requires independent decision-making within established guidelines and directly supports revenue continuity, compliance posture, and competitive positioning.

Requirements

Bachelor’s degree preferred or equivalent professional experience.
2+ years of experience in healthcare credentialing, provider enrollment, licensing, compliance, or RFP coordination required.
Proficiency in Microsoft Office Suite, Salesforce, Adobe Acrobat, credentialing platforms/portals, and document management systems.

Nice To Haves

Working knowledge of Medicaid, Medicare Advantage, MCO, and state Medicaid credentialing processes preferred.
Experience contributing to RFP preparation or maintaining proposal documentation strongly preferred.

Responsibilities

Prepare, submit, track, and follow up on credentialing and enrollment applications for Medicaid agencies, MCOs, IDNs, Medicare Advantage plans, and other commercial or government payers.
Maintain accurate and up-to-date credentialing files for company entities, facilities, and assigned clinical or non-clinical personnel.
Coordinate renewals, updates, revalidations, and filings to ensure zero lapses in provider or organizational status.
Review payer contracts, state requirements, and program terms to determine applicable credentialing or enrollment obligations.
Monitor application statuses and proactively follow up with payers or agencies to ensure timely approvals.
Escalate complex or high-risk items appropriately with recommended next steps.
Prepare and submit credentialing, licensing, compliance, and operational sections of Requests for Proposals (RFPs) and related bid documents.
Ensure responses are accurate, aligned with current licensing and enrollment status, and submitted within required deadlines.
Collaborate with Sales, Compliance, Legal, and Operations teams to ensure RFP responses reflect accurate program capabilities and regulatory standing.
Maintain and update the credentialing and compliance source content library, including standard narratives, licensing documentation, policies, and required attachments.
Ensure version control and document accuracy across shared platforms (e.g., Salesforce, SharePoint, proposal libraries).
Regularly validate that stored documentation reflects current regulatory status and organizational capabilities.
Identify outdated or inconsistent materials and proactively update to maintain audit readiness and proposal accuracy
Partner with Compliance, HR, Operations, Sales, and Legal teams to ensure credentialing and RFP requirements align with workforce onboarding, contract execution, and implementation timelines.
Respond to stakeholder inquiries within established service standards.
Participate in implementation planning for new states, markets, payer contracts, and RFP opportunities.
Communicate timelines, risks, and dependencies clearly and professionally
Maintain accurate records in Salesforce, SharePoint, credentialing platforms, RFP systems, and applicable payer portals.