Position: Licensing Specialist

Monogram Health is seeking an individual who has worked at either a large clinical organization, provider group, third-party licensing company or medical staff office. The licensing specialist contributes to the ongoing advancement of the organization's goals by ensuring practitioners are licensed timely and in compliance with state regulations. Licensing assignments will be determined by business needs as communicated by operational/clinical leadership. The licensing specialist Identifies, analyzes, and resolves information discrepancies, and time gaps that could adversely affect our organization's ability to license practitioners. The licensing specialist is responsible for maintaining accurate and comprehensive data in credentialing software and shared drives.

The licensing specialist must have overall knowledge of state medical licensure process for physicians and mid-level practitioners. The licensing specialist must stay up to date on collaborative practice agreement requirements across all states and serve as a subject matter expert for clinical leadership. The licensing specialist is committed to maintaining consistent, accurate, detailed, and organized records that can be subject to internal, health plan and NCQA audits at any time.

Prior to applying to Monogram Health, ideal candidates may have had successful roles such as: Licensing Coordinator, Licensing Specialist, Licensing Team Lead, Credentialing Verifier, Credentialing Specialist, Credentialing Team Lead, Medical Staff Office Professional, Provider Enrollment Specialist, PES Account Manager, PES Team Lead.

Possessing these traits may indicate high compatibility for role: Flexible, detailed and process oriented, affinity for accuracy, deadline conscientious, excellent documentation skills, adaptable, strategic and organized.

Roles and Responsibilities

• Responsible for state licensure, DEA, CDS and collaborative practice agreements for a variety of practitioner types which includes (but is not limited to): Physicians, Nurse Practitioners, Registered Nurses, and Licensed Clinical Social Workers.
• Prepare detailed cover letters/email correspondence with step-by-step application instructions to inform practitioner how to effectively complete and return the application, including steps to acquire supporting documents as well as complete the applications to the fullest to allow faster processing time by the practitioner.
• Expedite licensure application process by creating urgency with practitioner via phone and email to collect relevant information to submit to the board and meet start date.
• Follow Licensing and Credentialing Escalation Pathway for practitioners or applications with outstanding items/information needed to finalize the licensing process
• Create urgency with institutions through making follow-up calls to expedite verification completion and submission to state boards
• Coordinate submission of all practitioner verifications required by state boards by calling institutions listed in practitioner work history and education in order to expedite on-time submittal of verification information.
• Prioritize application submissions based on business needs and department guidance
• Provide transparent and timely communication to internal team and greater MH community
• Follow up with issuing state board to assess licensure status and expected completion date. Effectively communicate that information to Licensing & Credentialing Dept, Operations and Clinical Leadership.
• Notify Credentialing team of initial license issuances and renewals as needed to maintain uninterrupted credentialing and payor enrollment
• Submit CPAs for practitioners as needed to remain compliant with state regulations
• Ensure all licensing and CPA data entered accurately and timely in the credentialing database. Complete regular audits to maintain data integrity.
• Document, note and upload all critical lifecycle events in credentialing software (ie. Application Received, Requests for Information, State Background Checks, Fingerprints, Transcript Requests, State Board/DEA/CDS Review and Approval, Issuance)
• Update team and healthcare providers via regular meetings and documents/notates follow-ups of every step/interaction to keep status updates of licensure process.
• Ensure all practitioner clinical information is accurately entered into HR, CME, CVO and Credentialing databases.
• Experience with generating reports to identify daily workflow
• Run monthly expirable reports to identify those practitioners with upcoming expiring licenses and certifications. Notify and follow-up with providers for expiring items
• Work with internal MH departments and practitioner to ensure streamlined onboarding and renewal of expiring items
• Complete recurring audits/data reconciliation as directed by management
• Routinely evaluate reporting needs and execute and escalate reporting requirements to management
• Complete recurring audits/data reconciliation as directed by management
• Self-directed learner, must be competent when asked to complete tasks new to MH or practitioner type and state
• Able to take advantage of department training/resources for self-guided learning
• Understand and follow MH Credentialing policy and procedure
• Must keep all information confidential
• Other duties as assigned

Position Requirements

• Bachelor's Degree preferred
• 3-5 years' experience required
• Experience obtaining physician (MD/DO) state licenses, controlled substance licenses, and DEA licenses. Monitoring, managing, maintaining
• Experience filing/amending collaborative practice agreements
• Research of CME requirements by state
• Experience managing licensing volume across multiple states
• Proficiency in Microsoft office applications (e.g. Word, Excel, PowerPoint) and Smartsheet
• Excellent attention to detail
• Creative and persistent problem solver
• Ability to research data and draw conclusions
• Must be able to work in a independent manner and manage multiple simultaneous time-sensitive deliverables
• Ability to communicate effectively with a variety of contacts including senior management, government agencies/licensing board and other business associates
• Must possess excellent verbal and written communication skills
• Client service oriented
• Attention to detail and accuracy
• Able to handle confidential information in a reliable manner
• Strong interpersonal skills to handle sensitive situations and confidential information
• Position continually requires demonstrated, poise, tact, diplomacy and good judgment

Benefits

• Opportunity to work in a dynamic, fast-paced and innovative care management company that is transforming the delivery of kidney care
• Competitive salary
• Comprehensive medical, dental, vision and life insurance
• Flexible paid leave & vacation policy
• 401(k) plan with matching contributions

About Monogram Health

Monogram Health is a next-generation, value-based chronic condition risk provider serving patients living with chronic kidney and end-stage renal disease and their related metabolic disorders. Monogram seeks to fill systemic gaps and transform the way nephrology, primary care and chronic condition treatment are delivered. Monogram's innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum. By focusing on increasing access to evidence-based care pathways and addressing social determinants of health, Monogram has emerged as an industry leader in championing greater health equity and improving health outcomes for individuals with chronic kidney and end-stage renal disease.

At Monogram Health we believe in fostering an inclusive environment in which employees feel encouraged to share their unique perspectives, leverage their strengths, and act authentically. We know that diverse teams are strong teams, and welcome those from all backgrounds and varying experiences.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.