License Regulatory Specialist
15 days ago
Overland Park
Job Description Company Overview: BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medications. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes. At BioMatrix the heart of our Inclusion, Diversity, Equity, & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone’s contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients, employees, and partners. Schedule: It is anticipated that an incumbent in this role will work Monday through Friday between 8:30am and 5pm Central Standard Time. Schedule subject to occasional change based on business needs. Location: It is anticipated that an incumbent in this role will work on-site at our location in Overland Park, KS. Job Description: The Licensure and Regulatory Specialist is responsible for managing and maintaining all aspects of licensure, credentialing, and regulatory compliance for the company’s ambulatory infusion centers (AICs) and ambulatory infusion suites (AISs). This includes ensuring compliance for the facilities themselves as well as for employed or contracted clinical staff, such as nurse practitioners, medical directors, and other licensed healthcare professionals. The Specialist plays a vital role in maintaining the organization’s regulatory readiness and supporting timely enrollments with federal and state programs. The Licensure and Regulatory Specialist will assist the Senior Licensure and Regulatory Specialist in managing the logistics of the Company’s licensing and enrollments, including state, federal, and regulatory requirements. QUALIFICATION REQUIREMENTS • Bachelor’s degree in healthcare administration, Business, or a related field (or equivalent experience)., • Minimum of 3–5 years of experience in healthcare licensure, credentialing, or regulatory compliance, preferably in an infusion or ambulatory care setting., • Experience with Medicare and Medicaid enrollment systems (PECOS, NPPES, state portals) required., • Knowledge of multi-state licensing requirements and regulatory nuances., • Experience supporting facility accreditation (e.g., ACHC, URAC, Joint Commission) preferred., • Advanced level skill in MS Office (including Word, Excel, PowerPoint, etc.), • Willing to travel up to 10% of the time for business purposes (when necessary to attend meetings, conferences, seminars, etc.) ESSENTIAL FUNCTIONS AND RESPONSIBILITIES • Tracks license and certification expirations for all providers to ensure timely renewals., • Prepare, submit, and manage Medicare and Medicaid enrollment and revalidation applications for facilities and providers., • Track enrollment progress and coordinate with payers to ensure timely processing and activation., • Maintain up-to-date NPI and PECOS records for facilities and clinicians., • Maintenance of NPI websites uploading of new licenses/permits, ensuring demographic, location and provider and facility information is submitted and current., • Maintain accurate, organized, and auditable documentation of all licensure and regulatory submissions., • Develop and maintain tracking systems or databases to manage status reports, expiration dates, renewal schedules, and compliance documentation., • Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed., • Manage and maintain active licensures for all ambulatory infusion centers and affiliated practice sites across applicable states., • Coordinate the acquisition, renewal, and verification of state facility licenses, CLIA certifications, DEA registrations, and other required credentials., • Oversee the credentialing and recredentialing process for nurse practitioners, medical directors, and other clinical personnel, ensuring compliance with payer and regulatory requirements., • Maintains copies of current state licenses, certificates, insurance coverage, and any other required credentialing documents for all providers., • Ensures proper reporting to enforcement agencies as appropriate and/or required., • Track and submit expenses as related to changes for licensure application and renewals., • Notifying applicable payors, Medicare, Medicaid, and/or licensing boards of any changes i.e., change in ownership, change of location, change of name, etc., • Performs other tasks as requested by the Senior Licensure and Regulatory Specialist and Legal Team., • Company notary for locations within state requirements. KNOWLEDEGE, SKILLS AND ABILITIES REQUIREMENTS • Strong knowledge of healthcare licensing and credentialing standards., • Familiarity with CMS, state health departments, and payer enrollment requirements., • Excellent attention to detail, organization, and documentation skills., • Strong written and verbal communication skills., • Proficiency in Microsoft Office Suite and credentialing management software (e.g., CAQH, ProviderSource, or similar)., • Ability to manage multiple projects, meet deadlines, and work independently with minimal supervision., • Planning/Organizing- Uses time efficiently; sets goals and objectives; Develops realistic action plans., • Demonstrates accuracy and thoroughness., • Able to create and implement systems required to gather, maintain, and analyze information. PHYSICAL DEMANDS AND WORK ENVIRONMENT • This position requires constant sitting with occasional walking, standing, kneeling, or stooping., • This position requires the use of hands to finger, handle or feel objects and the ability to reach with hands and arms., • This position requires constant talking and hearing., • Specific vision abilities required by this job include close vision and the ability to adjust focus., • This position must occasionally lift and/or move up to twenty pounds., • Required to move/lift physical hardware. AMERICANS WITH DISABILITY SPECIFICATIONS - PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to twenty-five pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. OTHER • Will participate in legal and ethical compliance training each year., • Will consistently behave in compliance with the BioMatrix, LLC’s legal and ethical policies and procedures., • Will abide by the policies of BioMatrix as set forth in the Compliance Manual., • Will not participate in any conduct considered to be unethical or illegal. EXPECTATION FOR ALL EMPLOYEES Supports the organization's mission, vision, and values by exhibiting the following behaviors: integrity, dedication, compassion, enrichment, and enthusiasm. GENERAL INFORMATION: The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified. The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate. Incumbents within this position may be required to assist or find appropriate assistance to make accommodations for disabled individuals in order to ensure access to the organization's services (may include visitors, patients, employees, or others).