About the job
As a Compliance Manager at distro, you will play a pivotal role in overseeing provider enrollment, licensing, and credentialing processes for home care, home health, and hospice agencies. Your expertise will ensure that our operations adhere to state and federal regulations.
Schedule:
• Monday to Friday
• 8:00 AM – 6:00 PM (EST)
Key Responsibilities:
• Oversee the complete cycle of state licensing, credentialing, Medicaid and Medicare enrollment, and regulatory documentation.
• Lead the administration and execution of all Provider Enrollment contracts.
• Collaborate with the Sales team on commercial calls and contract reviews.
• Address client inquiries, complaints, and clarifications efficiently.
• Serve as the Application Traffic Coordinator, ensuring smooth operations.
• Prepare and manage detailed monthly reports, including financial liabilities and application trackers.
• Navigate state-specific challenges in collaboration with Ombudsman Offices and State Supervisors.
• Draft and revise Medicaid Waiver application policies and procedures.
• Conduct regulatory research to support internal teams and sales efforts.
• Prepare and review Corrective Action Plans and required documentation for state authorities.
• Ensure accuracy and completeness in licensing, credentialing, and provider enrollment applications.
• Communicate effectively with clients to gather essential documentation.
• Stay informed about state regulations and insurance program requirements.
• Maintain documentation, requirements, and application status in the CRM system.
• Educate clients on timelines, requirements, and expectations throughout the process.
• Manage customer calls and correspondence efficiently.
• Input new contracts into the CRM (Nutshell).
• Organize client documents on the Shared Drive.
• Audit and correct monthly reports as required.
• Process application cancellations and termination agreements promptly.
• Provide administrative support, including copying, faxing, and mailing.