Licensure and Credentialing Specialist Job at SpineZone, San Diego, CA

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  • SpineZone
  • San Diego, CA

Job Description

The Company 

  • CEO: Rob Cohen 
  • Investors: A1 Health Ventures, Martin Ventures, Polaris Partners, Providence Ventures
  • Website: livarahealth.com
 

Company Description  

Livara is reimagining musculoskeletal care for value-based provider groups and health plans. With an interdisciplinary, biopsychosocial, and high-touch clinical model, Livara works with payors, risk-bearing providers, and health systems to improve outcomes, reduce costs, and fill gaps in the current musculoskeletal (MSK) care model. 

Livara, created by way of the legacy SpineZone business alongside investments by A1 Health Ventures, Martin Ventures, Polaris Partners, and Providence Ventures, operates a hybrid clinical model. The company’s digital care delivery, care management, and care navigation platform offers online services in 14 states while in-person care is provided through 10 company-owned SpineZone clinic sites in Southern California and partnerships with 3rd party clinics elsewhere. The high touch, multi-service focus allows patients to get the high quality care they need. 

With the MSK space being extremely fragmented and lacking cohesion between Primary Care Physicians, Physical Therapists, and Surgeons, there are many barriers for companies to enter the value-based care world. Livara’s fully integrated pathway brings everything together in one place, creating a seamless experience. The company brings a highly clinical and data-driven approach to MSK care, with a solution focused on 3 main pillars: care planning, care delivery, and care navigation. The system is designed to predict and qualify clinical risk factors to highlight where the biggest impact is going to be. From there, Livara is able to take the continuous flow of data from the patient to the clinician and quickly adjust any treatment course based on these results. 

Livara is pioneering value-based contracts in the MSK space, headed by CEO Rob Cohen and Co-Founder and Chief Medical Officer (CMO) Kamshad Raiszadeh. Unlike most competitors, the company takes on risk and focuses on Medicare and fully insured populations, with key partners that include Elevance, Providence, and Scripps. 

 

The Role

Reporting directly to Pamela Erickson, VP, People and Culture, Livara is looking for a mission-driven Information Medical Staff Credentialing Specialist.  The Licensure and Credentialing Specialist is responsible for ensuring that healthcare providers within our organization are properly licensed, credentialed, and comply with all regulatory and accreditation standards. This role involves managing the credentialing and re-credentialing processes for all providers, maintaining up-to-date and accurate records, ensuring timely renewals of licenses and certifications, and applying for providers' licensure in all 50 states. If you are passionate about making a difference and being part of an innovative team, we want to hear from you!

As a Medical Staff Credentialing Specialist at Livara you will:

 
  1. Credentialing and Licensure Management:
  • Maintain individual provider files with up-to-date information for governmental and commercial payer credentialing applications.
  • Apply for and manage provider licensure in all 50 states, ensuring compliance with state-specific requirements and regulations.
  • Ensure timely renewal of licenses, certifications, and insurance.
  • Terminate enrollment with government and commercial payers upon provider resignation or termination.
  1. Records and Compliance:
  • Create and maintain licensing, credentialing, and insurance records.
  • Monitor expiration dates for licenses, certifications, and insurance; advise staff members of renewal deadlines.
  • Ensure compliance with regulatory and accrediting institutions.
  • Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases.
  • Conduct primary source verification for new and existing providers.
  1. Communication and Coordination:
  • Act as a liaison between providers and various internal and external stakeholders.
  • Release information to requesting agencies and public inquiries as required by law.
  • Provide expertise and guidance to providers and medical organizations on credentialing matters.
  1. Process Improvement and Reporting:
  • Identify potential onboarding issues or concerns; research, provide clarification, and facilitate problem resolution.
  • Keep up-to-date with changing laws and regulations affecting credentialing and licensure.
  • Prepare and present licensure progress reports to the team lead.
  1. Support:
  • Assist with fingerprinting for employees.
  • Organize new employee personnel files and verify that required documentation is accurate.

We’d love to talk more if you have:

  • High School Diploma required; Bachelor’s degree in Healthcare Administration, Business Administration, or a related field preferred.
  • Minimum of 2 years of experience in credentialing, licensure, or a related field within the healthcare industry. Direct credentialing and provider enrollment experience required.
  • Strong computer skills, proficiency in G-Suite, and credentialing software/databases. Experience with PECOS, NPPES, CAQH, Managed Care Organizations, commercial plans, and various clearinghouses like Navinet and Availity.
  • Strong attention to detail and organizational skills; experience tracking license and certification expirations for providers.
  • Excellent verbal and written communication skills; ability to maintain professional relationships and boundaries.
  • Critical thinking and problem-solving skills.
  • Excellent time management skills and ability to manage multiple tasks and meet deadlines.
  • Desire to be part of a cohesive, fast-paced, dynamic team; willingness to work hard and learn.
  • Familiarity with regulatory and accreditation standards related to healthcare credentialing and licensure.

Physical Requirements:

  • Prolonged periods of sitting at a desk and working on a computer.
  • Must be able to lift up to 15 pounds at times.

Work Environment:  This position offers a hybrid work arrangement, combining both in-person and remote work. The role requires the employee to work in the office and allows for remote work on some days. Specific in-office requirements will be communicated based on business needs and project requirements.

Travel Requirements:  This position requires some travel.

Job Type: Full-time, Hourly, Hybrid (Remote and In-Office)

 

Why Join Livara Health, Inc.?

Livara Health, Inc., is a great place to be if you are passionate about helping others and want a place to grow!

 

Compensation Range, DOE (Hourly, Non-Exempt):  

$24.00 - $29.00

 

We offer benefits including:

  • Medical
  • Dental
  • Vision
  • Life Insurance
  • Long Term Disability
  • 401k with match and generous PTO
  • Tuition Assistance
  • EAP (Employee Assistance Program)
  • Paid Sick Leave
  • Career Growth opportunities! 
 

Livara Health, Inc., is an Equal Opportunity Employer: we value diversity. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Job Tags

Hourly pay, Full time,

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