License Regulatory Specialist
About The Position
The Licensure and Regulatory Specialist is responsible for managing and maintaining all aspects of licensure, credentialing, and regulatory compliance for the company’s ambulatory infusion centers (AICs) and ambulatory infusion suites (AISs). This includes ensuring compliance for the facilities themselves as well as for employed or contracted clinical staff, such as nurse practitioners, medical directors, and other licensed healthcare professionals. The Specialist plays a vital role in maintaining the organization’s regulatory readiness and supporting timely enrollments with federal and state programs. The Licensure and Regulatory Specialist will assist the Senior Licensure and Regulatory Specialist in managing the logistics of the Company’s licensing and enrollments, including state, federal, and regulatory requirements.
Requirements
- Bachelor’s degree in healthcare administration, Business, or a related field (or equivalent experience).
- Minimum of 3–5 years of experience in healthcare licensure, credentialing, or regulatory compliance, preferably in an infusion or ambulatory care setting.
- Experience with Medicare and Medicaid enrollment systems (PECOS, NPPES, state portals) required.
- Knowledge of multi-state licensing requirements and regulatory nuances.
- Advanced level skill in MS Office (including Word, Excel, PowerPoint, etc.)
- Willing to travel up to 10% of the time for business purposes (when necessary to attend meetings, conferences, seminars, etc.)
- Strong knowledge of healthcare licensing and credentialing standards.
- Familiarity with CMS, state health departments, and payer enrollment requirements.
- Excellent attention to detail, organization, and documentation skills.
- Strong written and verbal communication skills.
- Proficiency in Microsoft Office Suite and credentialing management software (e.g., CAQH, ProviderSource, or similar).
- Ability to manage multiple projects, meet deadlines, and work independently with minimal supervision.
- Planning/Organizing- Uses time efficiently; sets goals and objectives; Develops realistic action plans.
- Demonstrates accuracy and thoroughness.
- Able to create and implement systems required to gather, maintain, and analyze information.
Nice To Haves
- Experience supporting facility accreditation (e.g., ACHC, URAC, Joint Commission) preferred.
Responsibilities
- Tracks license and certification expirations for all providers to ensure timely renewals.
- Prepare, submit, and manage Medicare and Medicaid enrollment and revalidation applications for facilities and providers.
- Track enrollment progress and coordinate with payers to ensure timely processing and activation.
- Maintain up-to-date NPI and PECOS records for facilities and clinicians.
- Maintenance of NPI websites uploading of new licenses/permits, ensuring demographic, location and provider and facility information is submitted and current.
- Maintain accurate, organized, and auditable documentation of all licensure and regulatory submissions.
- Develop and maintain tracking systems or databases to manage status reports, expiration dates, renewal schedules, and compliance documentation.
- Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
- Manage and maintain active licensures for all ambulatory infusion centers and affiliated practice sites across applicable states.
- Coordinate the acquisition, renewal, and verification of state facility licenses, CLIA certifications, DEA registrations, and other required credentials.
- Oversee the credentialing and recredentialing process for nurse practitioners, medical directors, and other clinical personnel, ensuring compliance with payer and regulatory requirements.
- Maintains copies of current state licenses, certificates, insurance coverage, and any other required credentialing documents for all providers.
- Ensures proper reporting to enforcement agencies as appropriate and/or required.
- Track and submit expenses as related to changes for licensure application and renewals.
- Notifying applicable payors, Medicare, Medicaid, and/or licensing boards of any changes i.e., change in ownership, change of location, change of name, etc.
- Performs other tasks as requested by the Senior Licensure and Regulatory Specialist and Legal Team.
- Company notary for locations within state requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
