Payor Enrollment Specialist

Vori Health is an award-winning, nationwide, virtual-first, musculoskeletal medical practice focused on evidence-based care that treats the whole person. Using a unique care model to help patients find the best path forward, Vori Health connects patients to a trained care team that includes a nonoperative physical medicine physician, a health coach navigator, and a physical therapist who manage the initial patient assessment and then work to coordinate all aspects of care. We are on a mission to empower humanity to lead a healthier life.  

The Payor Enrollment Specialist will be responsible for ensuring that our provider pool has all the appropriate licensing and credentialing to serve Vori Health members in their assigned regions of practice. The role will entail driving and maintaining a detailed database of the certifications, licenses, and credentials of each provider in the Vori Health roster. This individual will also be responsible for monitoring the provider roster for gaps or potential expirations/renewals that need to be addressed through timely action. They will also work with the clinical team to ensure that all appropriate documentation and requirements are completed and filed with the appropriate entities.   

What You’ll Do: 

  • Essential Functions: 
  • Proactively develop and drive forward an internal process for completing and submitting applications/renewals and other required compliance related documentation to appropriate entities with minimal defects/delays and maximum efficiency.   
  • Serve as initial and final reviewer of the provider/applicant’s licensing and medical credentialing applications to assure compliance with each entity’s specific requirements and standards.    
  • Regularly report out to clinical and operational teams and leadership on status of in-flight applications and actions that need to be taken.   
  • Manage an internal database of Vori Health providers and the status of their various licenses and credentials.   
  • Perform medical credentialing file/element investigation and primary source verification of provider’s initial and re-credentialing applications, utilizing established Standards, Client specifications and federal and state regulatory requirements.   
  • Continually track the progress against gaps in the required licensing and credentialing landscape and identify critical gaps or lack of progress that could pose a risk to the continuity of expansion of business.  
  • Supervisory Responsibilities: 
  • N/A 
  • Perform other projects and duties as assigned 

Who You Are: 

  • Required: 
  • Minimum 3 years’ experience in licensing/credentialing in a provider setting  
  • CPCS and/or PESC certifications a plus   
  • Deep understanding of clinical licensure and credentialing nuances across multiple states  
  • Proven track record in independently driving forward projects, operational improvement or change management initiatives with measurable outcomes  
  • Hands-on experience managing medical credentialing data following established standards  
  • Proficiency in Office365, Trello/JIRA/Airtable/other project management software  
  • College degree, preferably in business or healthcare administration  
  • Nice-to-Haves: 
  • Comfort working within an environment of rapid pace, high uncertainty, and constant change  
  • Outstanding written and spoken communication skills across various channels and groups and managing team conflict  
  • Ability to maintain attention to details while also seeing the big picture   
  • Experience working closely with clinical teams to accomplish shared goals and drive positive collaboration    
  • Graceful at managing expectations while pushing for continuous improvement 
  • Work authorization/security clearance requirements: 
  • N/A 
  • Physical Requirements/Work Environment: 
  • Remote work environment 
  • Prolonged periods of sitting or standing at a desk and working on a computer 

How We Hire

  1. Apply: Submit an application.
  2. First Hello: Phone interview with a Talent Acquisition Specialist.
  3. Meet Your Leader: Discuss your background and explore a relationship with you would report to.
  4. Meet the Team: Be introduced to prospective team members. For IT positions, this will be a technical interview.