Compliance and Credentialing Specialist

at

Circle Medical

Worldwide
Full Time
11mo ago
ABOUT US

Circle Medical is a venture-backed Y-Combinator healthcare startup on a mission to bring quality, delightful primary care to everyone on the planet. Built by top-tier physicians, engineers, and designers, our medical practice and underlying technology have pioneered how people find and receive care.

Our focus on building directly for our patients and providers to address serious care accessibility issues has enabled us to grow over 3X year-over-year. We’re now using our most recent round of funding from WELL Health, backed by Sir Li Ka-shing, to continue building out our hybrid in-clinic and telemedicine model across all fifty states.

As we enter the hypergrowth phase, we are looking for deeply motivated team players who are driven to solve some of the biggest challenges in healthcare so that people can live longer and healthier lives.

More about us can be found on our website!

We are looking for a Compliance & Credentialing Specialist who will report to the Director of Compliance & Policy. As we continue to grow, we are constantly searching for exceptional talent to be a part of our team. This position can be based out of our office in Montreal, San Francisco, NYC, or remote US for the right candidate.

As the Compliance & Credentialing Specialist, you will serve as a subject matter expert regarding healthcare compliance and regulatory requirements and will support the Director of Compliance & Policy in the continued development and operation of the compliance program, implementation of compliance plans, and management of compliance risk. In addition, you will monitor the credential status of our providers and be proactive in having them renewed before their expiration date, and provide credentialing support and backup to the Credentialing Coordinator as needed.

WHAT YOU’LL DO

    • Identify, investigate, and report compliance issues, irregularities, and violations
    • Track and respond to complaints
    • Maintain records of compliance activities
    • Preparing and filing compliance reports
    • Communicating with government agencies
    • Implement and manage an effective legal compliance program
    • Develop and review company policies
    • Advise management on the company’s compliance with laws and regulations through detailed reports
    • Create and manage effective action plans responding to audit discoveries and compliance violations
    • Regularly audit company procedures, practices, and documents to identify possible weaknesses or risks
    • Assess company operations to determine compliance risk
    • Ensure all employees are educated on the latest regulations and processes
    • Resolve employee concerns about legal compliance
    • Help lead and monitor all credentialing, re-credentialing, and provider enrollment processes
    • Maintain a database of employee certifications and renewal dates
    • Confirm that employee credentials match the requirements of their job
    • Help employees renew their credentials on time by finding test dates and locations
    • Ensure staff coordination and administration of the credentialing process for certified staff and providers at CM
    • Review, analyze and create practitioner credentialing applications, privileging forms, and standardized communications in an effort to improve communication and compliance
    • Identify and communicate all concerns regarding practitioner credentialing and enrollment to appropriate parties; follow up when necessary to ensure affected parties and departments are notified of concerns in an appropriate time frame
    • Other duties as assigned by management/leadership

WHAT YOU’LL BRING

    • A Certified Risk and Compliance Management Professional (CRCMP) is preferred.
    • 2+ years of credentialing experience with medical staff
    • At least six months in a health-tech environment OR 2 years in a traditional healthcare environment
    • The ability to think logically and analytically to problem-solve on a daily basis.
    • Have emotional intelligence and the ability to possess self-awareness and base decisions on your analysis of facts.
    • Advanced research and google search capabilities
    • Strong time management and prioritization skills to make sound business decisions.
    • In-depth knowledge of the clinical, healthcare, and telemedicine standards, regulations, and medical credentialing and privileging procedures and standards.
    • Excellent communication skills; written, verbal, as well as auditory
    • Familiarity with healthcare, telehealth, and regulatory terminology.
    • Professional integrity to adhere to professional confidentiality standards in accordance with legal, ethical, and company policies
    • Ability to recognize problems, collect data and establish facts quickly and under deadlines.
    • Critical thinking skills to exercise sound judgment and discretion in applying departmental policies and procedures while handling confidential medical staff, risk management, and peer review information.

WHAT WILL GIVE YOU AN EDGE

    • Experience in the healthcare industry
    • Proven track record with other startups or VC-funded companies 
    • Experience in healthcare & health-tech environments
    • Bachelor's degree in business, finance, or a related field preferred
    • Experience working remotely
COMPENSATION:
In alignment with our values, Circle Medical has transparent salaries based on location, output levels, and options to trade cash for stock. This is a full-time, salaried position with an annual salary (cash and stock combined) of $65,000 - $85,000 USD (depending on location) plus generous vacation, and full medical/dental benefits.

Circle Medical is proud to be an equal opportunity workplace. We are committed to equal employment opportunities regardless of race, colour, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status.
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Onkar By: Onkar