Regulatory Licensing & Enrollment Specialist

The Regulatory Licensing & Enrollment Specialist supports Renew Health & Recovery's multi-state regulatory licensing, accreditation, and payer enrollment activities, with a primary focus on facilitating organizational growth and expansion into new markets.

This position coordinates new state licensing applications, regulatory approvals, and ongoing licensure requirements while supporting The Joint Commission (TJC) accreditation activities and organizational compliance initiatives. The Specialist also assists with Medicare and Medicaid enrollment, facility credentialing, and commercial payer enrollment processes as needed to support operational readiness and continuity of services.

The ideal candidate is highly organized, detail-oriented, and comfortable researching regulatory requirements, coordinating complex applications, communicating with regulatory agencies, and managing multiple projects in a growing healthcare organization.

Salary Range: $55,000–$60,000 annually

ESSENTIAL RESPONSIBILITIES

Regulatory Licensing & Expansion

• Research and analyze state-specific licensing, certification, and regulatory requirements to support expansion into new markets.
• Coordinate and prepare initial licensing applications for new states, programs, services, and organizational entities.
• Support regulatory activities related to organizational growth, expansion into new states, and new program and service development.
• Serve as a primary point of contact with assigned state licensing and regulatory agencies.
• Manage assigned license renewals, amendments, regulatory updates, and required notifications.
• Maintain licensing trackers, application timelines, regulatory correspondence, and supporting documentation.
• Monitor changes in applicable state and federal regulations and communicate relevant updates and potential impacts to leadership.
• Collaborate with internal stakeholders to obtain required documentation and support timely regulatory submissions.
• Evaluate application requirements, identify potential regulatory barriers, and recommend solutions or escalation to leadership.

Accreditation & Survey Readiness

• Support ongoing compliance with The Joint Commission accreditation standards and requirements.
• Assist with accreditation applications, renewals, and organizational updates.
• Coordinate documentation and preparation activities for licensing and accreditation surveys.
• Participate in mock surveys, tracers, and regulatory readiness assessments as assigned.
• Develop and maintain accreditation checklists, monitoring tools, and regulatory tracking resources.
• Assist with corrective action plans and required follow-up submissions.
• Collaborate with operational leadership to support continuous survey readiness.
• Provide guidance and education to internal stakeholders regarding applicable regulatory and accreditation requirements.

Payer Credentialing & Enrollment Support

• Assist with organizational and facility credentialing and enrollment with commercial payers, Medicare, and Medicaid as needed.
• Support payer credentialing applications, renewals, recredentialing, and demographic updates.
• Coordinate collection and submission of organizational, licensing, accreditation, and provider documentation required for payer participation.
• Assist with Medicare and Medicaid enrollment applications and related updates when assigned.
• Support payer enrollment activities associated with new states, organizational entities, and program expansion.
• Maintain credentialing and enrollment trackers, monitor application status, and follow up on outstanding requirements.
• Communicate with payer representatives and enrollment agencies to facilitate application processing.
• Collaborate with internal departments to support timely enrollment and network participation.

Compliance & Organizational Support

• Support regulatory compliance initiatives, internal monitoring activities, and organizational improvement projects.
• Assist with regulatory research and review of organizational policies and procedures.
• Develop and maintain standardized regulatory checklists, reporting tools, and compliance documentation.
• Support internal audits, compliance reviews, and corrective action follow-up as assigned.
• Collaborate with Human Resources, Learning & Development, and operational leadership to support regulatory education and readiness.
• Prepare status reports and updates related to licensing, accreditation, and enrollment activities.
• Participate in organizational committees, workgroups, and special projects as assigned.
• Monitor and respond to assigned Compliance department communications.
• Perform other related duties as assigned.

QUALIFICATIONS

Required

Education & Experience

• Bachelor's degree in healthcare administration, business administration, public health, or a related field, or an equivalent combination of education and relevant experience.
• Minimum of three years of experience in healthcare regulatory licensing, accreditation, compliance, or a related healthcare administrative function.
• Experience coordinating regulatory applications, renewals, or licensing documentation.
• Familiarity with healthcare regulatory requirements and accreditation processes.

Knowledge, Skills & Abilities

• Strong organizational skills and exceptional attention to detail.
• Ability to independently manage multiple projects, deadlines, and competing priorities.
• Strong research and analytical skills, including the ability to interpret regulatory requirements and technical documentation.
• Excellent written and verbal communication skills.
• Ability to communicate professionally with regulatory agencies, payers, and internal stakeholders.
• Proficiency with Microsoft Office 365, including Excel, Word, and Outlook.
• Ability to develop and maintain accurate tracking systems, records, and reports.
• Strong problem-solving skills and ability to identify and escalate issues appropriately.
• Ability to work independently in a remote environment and collaborate effectively across departments.
• Ability to maintain confidentiality and exercise sound professional judgment.

Preferred

• Experience in behavioral health, substance use disorder treatment, or other regulated healthcare settings.
• Experience with multi-state healthcare licensing and organizational expansion.
• Knowledge of The Joint Commission Behavioral Health Care accreditation standards.
• Experience with Medicare and Medicaid provider enrollment, including organizational or facility enrollment.
• Experience with commercial payer credentialing and enrollment processes.
• Familiarity with PECOS, NPPES, CAQH, state Medicaid enrollment portals, and payer credentialing systems.
• Experience supporting multi-state healthcare expansion, new entity licensing, and new program launches.
• Knowledge of healthcare compliance requirements, including HIPAA and applicable state and federal regulations.
• Experience with regulatory monitoring, policy and procedure review, and survey preparation.

CORE COMPETENCIES

• Organization and attention to detail
• Initiative and accountability
• Regulatory research and analytical thinking
• Project coordination and time management
• Professional communication
• Collaboration and teamwork
• Adaptability and problem-solving
• Integrity and confidentiality
• Commitment to regulatory compliance and quality improvement

ADDITIONAL INFORMATION

This position is an individual contributor role without direct supervisory responsibilities. The Specialist is expected to independently coordinate assigned regulatory licensing and enrollment activities while working under the direction of the VP of Regulatory Compliance & Quality. Final regulatory determinations, payer contract negotiations, and enterprise compliance oversight remain with designated leadership.

This job description is intended to describe the general nature and level of work performed and is not an exhaustive list of all duties, responsibilities, or qualifications. Responsibilities may evolve based on organizational needs.

Benefits Highlights:

Coverage: Health, vision and dental through Cigna, FSA, HSA that comes with an employer match, along with STD, LTD, life insurance, EAP, and more. 
Balance: Competitive accrued Paid Time Off (PTO) plan, 10 paid Holidays, 2 paid floating Holidays of your choice, and 7 days of Sick Time. 
Development: Certification/continuing education eligibility, leadership development and 1 paid day off a year to go towards personal professional development. 
Retirement: 401(k) retirement plan with Voya.
Culture: Dedication to diversity, equity and inclusion, and a growing working environment. 
*In order to be eligible for our full benefits package you must be employed full time at a minimum of 32 hours a week* 

EEO Statement:
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.