Provider & Facility Licensing and Credentialing Consultant / Contractor

Job Description

Job Description

Salary : $40-$125

Overview

Prosperous Health, Inc., a growing behavioral health management organization, seeks an experienced consultant or contractor to lead and manage all aspects of licensing, credentialing, and contracting of both providers and facilities with federal, state, and county payors. This role is critical to ensuring that our facilities and providers can bill and receive reimbursement under Medicare, Medicaid / Medi-Cal, and county behavioral health programs throughout California.

The ideal candidate has a strong background in healthcare compliance, credentialing, and payor relations, particularly in the behavioral health and substance use disorder sectors.

Key Responsibilities

• Licensing & Certification

Prepare and submit applications for federal, state, and county licensing (DHCS, CMS, county behavioral health departments, etc.)

Manage provider credentialing and re-credentialing with Medicare, Medi-Cal, and commercial payors

Negotiate and secure provider and facility contracts with Medicare, Medicaid / Medi-Cal, county behavioral health agencies, and managed care organizations

Monitor changes in federal, state, and county regulations that impact provider or facility participation

Qualifications

Engagement Terms