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NuvemRx · 2 months ago

Licensing & Credentialing Manager

United States

Full-time

Remote

Senior Level

5+ years exp

NuvemRx is a company focused on pharmacy management services, and they are seeking a Licensing & Credentialing Manager. This role is responsible for overseeing the licensing and credentialing processes for new pharmacy clients, ensuring compliance with regulatory requirements, and coordinating with various stakeholders throughout the implementation process.

Health CareHospital

Responsibilities

Manage the end-to-end licensing and credentialing process for new pharmacy locations, including state board of pharmacy licenses, DEA registration, NPI setup, and third-party payer enrollment

Coordinate with clients, pharmacy staff, and internal stakeholders to collect and submit all required documentation and applications accurately and on time

Monitor the progress of all applications and approvals; follow up with agencies or payers as needed to ensure timely completion

Maintain detailed records and tracking systems for all licensing and credentialing milestones and statuses

Ensure compliance with all federal, state, and local regulations related to pharmacy licensure and credentialing

Serve as subject matter expert on licensing and payer enrollment processes and requirements for all implementation projects

Work closely with project managers to align credentialing timelines with overall implementation plans and go-live dates

Develop and maintain standard operating procedures and tools for licensing and credentialing workflows

Identify and escalate delays or risks that may impact project timelines or regulatory compliance

Support renewals and recredentialing activities post-implementation

Forecast regulatory changes and proactively adjust internal procedures to stay ahead of compliance shifts

Develop dashboards or reporting tools to provide the Vice President of Professional Services real-time visibility into credentialing status across locations

Lead cross-functional team meetings to resolve credentialing challenges that span departments (e.g., IT, legal, operations)

Qualification

Pharmacy licensingCredentialing processesPayer enrollmentRegulatory complianceCredentialing management systemsMicrosoft OfficeAttention to detailCommunicationProblem-solving

Required

Bachelor's degree or equivalent work experience required

Minimum 5 years of experience in pharmacy licensing, credentialing, or payer enrollment, preferably in a multi-site or healthcare management environment

Thorough understanding of pharmacy regulatory requirements, state board processes, DEA registration, and payer enrollment procedures

Exceptional attention to detail, documentation, and organizational skills

Ability to manage multiple concurrent licensing and credentialing processes with accuracy and efficiency

Strong communication skills and experience working with external agencies and internal teams

Problem-solving mindset and ability to navigate bureaucratic or delayed processes with persistence

Proficient in Microsoft Office and credentialing management systems or tools