Credentialing & Licensing Manager

About TeleMed2U

At TeleMed2U, we believe that time is the most valuable resource in healthcare—whether it is time to diagnosis, time to treatment, or time to better health. That is why, since our founding in 2011, we have been dedicated to increasing access to care across 20 medical and behavioral health specialties nationwide. By breaking down traditional barriers to specialty care, TeleMed2U has become a leading technology-enabled healthcare services company, delivering high-quality, convenient, and easy-to-access virtual healthcare solutions.

Our integrated approach to chronic disease management empowers both patients and providers, improving health outcomes through seamless care coordination. With a focus on patient-centered innovation, provider collaboration, and data-driven care delivery, TeleMed2U is redefining specialty care—making it faster, simpler, and more accessible for all.

You will be responsible for all aspects of the credentialing and contracting. Responsible for ensuring providers are credentialed, appointed, and enrolled with health plans and managed care plans. Maintain up-to-date data for each provider in credentialing databases; ensure timely renewal of licenses and certifications. And all other credentialing and contracts duties as assigned.

Manages the TeleMed2U Provider Network’s credentialing process for all TeleMed2U clinical providers, in accordance with NCQA, URAC, Joint Commission, delegated contracts and CMS accreditation standards, Federal and State laws, and TeleMed2U’s policies.

• Coordinates the management of the credentialing database, ensuring accuracy of data and reporting to partnering systems. Monitors critical data for extensive analysis and report generation.
• Coordinates the management of TeleMed2U Provider Network’s credentialing applications, to ensure distribution, receipt, processing, and timely management through our credentialing process.
• Coordinates the management of the expirables process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
• Monitors and reports turnaround times for processing of credentials applications, with continued focus on efficient and timely delivery of a high-quality product.
• Manages Credentialing policies and procedures; develops, recommends, and/or implements changes, revisions, and enhancements as appropriate to current operating environment.
• Provides consultations with regards to credentialing practices and services; prepares and conducts credentialing orientations and provides updates as appropriate on new policies and procedures.
• Analyzes NCQA, URAC, delegation contracts, state laws and CMS standards and develops criteria to ensure compliance; revises general aspects of credentialing and privileging process as necessary; makes recommendations for and implements changes in policies and procedures.
• When applicable, prepares for and coordinates credentialing audits in compliance with managed care delegated credentialing contracts and accreditation bodies.
• Functions as primary TeleMed2U’s Provider Network credentials contact for all internal and external inquiries; develops and maintains positive working relationships.
• Represents TeleMed2U’s Provider Network to internal and external customers as appropriate; makes presentations to and interacts with various internal and external customers on issues pertinent to area of specialty.
• Maintains the TeleMed2U’s Provider Network. Keeps all necessary parties updated with changes to the Network provider list and field any inquiries regarding provider TeleMed2U’s Provider Network’s credentialing.

• Ensure CAQH profiles are regularly updated for TeleMed2U’s Provider Network.
• Prepare and submit spreadsheets to health insurance plans to ensure provider participation.
• Ensure various databases are updated for proper tracking of enrollments and update requests.
• Maintain necessary records of outstanding submissions and requests.
• Update the company/third party databases with the physician/provider's r and start date.
• Maintain familiarity and stay current with health…