Licensing & Credentialing Specialist

Peregrine Health; Nashville (TN); Presencial; USD 60.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive salary

Medical, dental, vision coverage

PTO & holidays

401(k) with employer match

Mental healthcare benefit

Fertility-care benefit

Bonus eligibility

Descripción de la vacante

Peregrine Health is hiring a Licensing and Credentialing Specialist to license behavioral health providers across states and credential them at partner centers. You’ll manage license applications, renewals, and credentialing file completeness to ensure timely start dates.

You will relentlessly pursue missing documents, coordinate verifications, and maintain CAQH/credentialing profiles to support coverage across sites.

Formación

• Two or more years of provider credentialing, licensing, or medical staff services experience.
• Experience assembling complete credentialing files and submitting them to health systems, payers, credentialing verification organizations, or delegated credentialing partners.
• Working knowledge of standard credentialing documentation, including state licenses, board certification, DEA and controlled substance registration, NPI, CAQH, malpractice coverage, and immunization requirements.
• Demonstrated follow-through on outstanding items, including persistent direct follow-up with busy clinicians.
• Strong attention to detail and the discipline to catch an incomplete or expired document before it is submitted.
• Ability to track many open files at once with accurate status on each.
• Clear, professional written and verbal communication with providers, partner organizations, and internal teams.
• Experience handling sensitive personal information appropriately and in compliance with privacy requirements.

Responsabilidades

• Collect and maintain provider information including NPI, CAQH credentials, Medicare/Medicaid numbers, and education history.
• Prepare and submit initial licensure and endorsement applications and track through issuance.
• Respond to state board requests and deficiency notices and resolve items promptly.
• Coordinate primary source verifications, supervision records, fingerprinting, background checks, jurisprudence exams, and CE documentation.
• Track renewal deadlines and continuing education requirements for all licenses.
• Maintain knowledge of multi-state licensure requirements and compact eligibility.
• Obtain complete credentialing documents and verify file completeness before submission.
• Submit packets and track status; follow up on stalled submissions.
• Drive provider follow-up to complete documentation before start dates.
• Keep CAQH and credentialing profiles current.
• Track expirations for licenses, certifications, DEA/CSR, BLS, malpractice, immunizations.
• Maintain organized, audit-ready provider files and Peregrine systems.
• Report licensing/credentialing status by provider and site; flag risks early.

Descripción del empleo

Employment Type: Full-time, Salary

Reports To: Designated Market Operations Leader

Role Summary

Peregrine Health is hiring a Licensing and Credentialing Specialist to get its behavioral health providers licensed in the states where they practice and credentialed at the partner health centers where they see patients. Peregrine employs psychiatric mental health nurse practitioners, licensed clinical social workers, and licensed professional counselors delivering care across multiple states.

On the licensing side, this role prepares and submits state license applications and renewals, tracks them through issuance, and resolves whatever the board comes back asking for. On the credentialing side, this role collects the full document set from each provider, verifies the file is complete and accurate for that provider type and state, submits it to the appropriate receiving party, and tracks it through to confirmation. In both cases, the role keeps every license, certification, and coverage document current before it lapses.

The right person is relentless about follow-up. Most licensing and credentialing delays come from a missing document a provider has not sent or a board request nobody answered. You will spend a significant part of your week chasing outstanding items and closing those gaps before they affect a start date.

Strategic Importance

A provider who is not licensed and credentialed cannot see patients. Every week of delay is a week of lost clinical capacity, delayed revenue, and a partner site waiting on coverage it was promised.

Peregrine is hiring providers across multiple states and partner organizations. Every state board has its own application, timeline, and quirks, and every partner has its own document requirements. Volume is increasing and none of it is uniform. This role exists to make licensing and credentialing predictable instead of a scramble tied to individual start dates.

Key Responsibilities

• Provider Information Intake: Collect and maintain personal, contact, and professional information for each provider, including NPI, CAQH credentials, Medicare and Medicaid numbers, employment history with dates, education history, and documented explanations for any gaps.
• State Licensure Applications: Prepare and submit initial license and endorsement applications to state boards for nurse practitioners, clinical social workers, and professional counselors, and track each application through issuance.
• Board Correspondence: Respond to state board requests, deficiency notices, and verification requirements, and resolve outstanding items without waiting for a follow-up from the board.
• Licensure Support Requirements: Coordinate the supporting steps each state requires, including primary source verifications, supervision records for endorsement, fingerprinting and background checks, jurisprudence exams, and continuing education documentation.
• License Renewals: Track renewal deadlines and continuing education requirements for every provider and every active state license, and complete renewals before expiration.
• Multi-State Licensure: Maintain working knowledge of licensure requirements, timelines, and compact eligibility for each state Peregrine operates in, and apply the correct requirements to each provider.
• Credentialing Document Collection: Obtain the complete required document set from each provider, including government-issued ID, Social Security card, professional diploma, official transcripts, resume, state licenses for all active states, board certification, DEA and controlled substance registration where applicable, BLS card, immunization records, malpractice insurance and certificate of insurance, claims history, and W-9.
• File Completeness Review: Verify each credentialing file against the requirements for that provider type, state, and receiving organization before submission, and identify missing, expired, or inconsistent items.
• Submission and Tracking: Submit complete packets to the appropriate receiving party, confirm receipt, track each submission through to approval, and follow up on anything that stalls.
• Provider Follow-Up: Drive outstanding documentation and application requests to completion with providers directly, escalating when a missing item puts a start date at risk.
• CAQH and Profile Maintenance: Keep provider CAQH profiles and related credentialing profiles current, complete, and attested on schedule.
• Expirables Management: Track expiration dates for licenses, board certifications, DEA and CSR registrations, BLS cards, malpractice coverage, and immunizations, and collect renewals before they lapse.
• Recordkeeping: Maintain organized, accurate, audit-ready provider files and keep licensing and credentialing status current in Peregrine's systems.
• Status Reporting: Report licensing and credentialing status by provider and site, and flag risks to start dates early enough to act on them.
• Sensitive Information Handling: Handle Social Security numbers, dates of birth, and other sensitive provider information in accordance with Peregrine's privacy and security policies.
• Process Documentation: Keep checklists, templates, state requirement references, and submission instructions current as requirements change.

Qualifications

Required

• Two or more years of provider credentialing, licensing, or medical staff services experience.
• Experience assembling complete credentialing files and submitting them to health systems, payers, credentialing verification organizations, or delegated credentialing partners.
• Working knowledge of standard credentialing documentation, including state licenses, board certification, DEA and controlled substance registration, NPI, CAQH, malpractice coverage, and immunization requirements.
• Demonstrated follow-through on outstanding items, including persistent direct follow-up with busy clinicians.
• Strong attention to detail and the discipline to catch an incomplete or expired document before it is submitted.
• Ability to track many open files at once with accurate status on each.
• Clear, professional written and verbal communication with providers, partner organizations, and internal teams.
• Experience handling sensitive personal information appropriately and in compliance with privacy requirements.

Preferred

• Experience credentialing behavioral health providers, advanced practice providers, or licensed clinical social workers and counselors.
• Multi-state credentialing or licensing experience.
• Experience with CAQH ProView, NPPES, PECOS, and state licensing board portals.
• Experience in an FQHC, rural health, community health, or multi-site care delivery setting.
• Familiarity with delegated credentialing arrangements and NCQA credentialing standards.
• Experience building or improving credentialing trackers, checklists, or reporting.
• Certified Provider Credentialing Specialist (CPCS) or equivalent certification.

Benefits

• Competitive salary.
• Full medical, dental, and vision coverage.
• 20 days of paid time off plus nine paid holidays.
• 401(k) with employer match.
• $1,800 annually toward mental healthcare.
• $5,000 fertility-care benefit.
• Bonus eligibility.