Credentialing Specialist

Be Part of Something Radically Different

At Holon Health, we don’t do “business as usual.” We’re a trailblazing healthcare startup reimagining what it means to care, for our clients and our people. We provide whole-person care to justice-involved individuals living with Substance Use Disorder (SUD), and we do it with deep compassion, community wisdom, and an unshakable belief in second chances.

Our approach throws out the playbook. We integrate medical, behavioral, and social care. We prioritize prevention and recovery. We treat clients like people, not checkboxes. And just as importantly, we know that our team can care for others if they’re cared for themselves. That’s why we lead with flexibility, trust, and a culture built on well-being, inclusion, and respect.

If you’re energized by meaningful work and want to feel good about how you spend your days, read on.

About the Role

Holon Health is seeking a Credentialing Specialist to support and safeguard the work that lets our providers deliver care. This role owns provider, credentialing, recredentialing, licensure management, and payer enrollment across multiple states, keeping our clinicians enrolled and maintained with commercial, Medicare, and Medicaid payers while staying compliant with regulatory, accreditation, and organizational requirements.

This is a role for someone who is organized, resourceful, and comfortable managing many moving pieces at. You will work closely with providers, health plans, regulatory agencies, and internal teams to keep credentialing and enrollment accurate and on time, and you will help build the processes that keep it that way as we grow into new markets.

What You’ll Do

Credentialing and Enrollment

• Coordinate initial credentialing, recredentialing, and payer enrollment for physicians, advanced practice providers, and other licensed clinicians.
• Manage Medicare, Medicaid, and commercial payer enrollment applications across multiple states.
• Perform primary source verifications and revalidations in line with payer, regulatory, and accreditation requirements.
• Submit and manage provider demographic updates, location additions, participation requests, and other enrollment changes.
• Monitor applications through completion and follow up proactively with payers to resolve delays or discrepancies.

Provider Data Management and Compliance

• Maintain the accuracy and integrity of provider credentialing files, databases, and reporting systems.
• Monitor and update external credentialing databases and portals, including CAQH, PECOS, NPPES, Availity, and state enrollment systems.
• Track and manage expirations for licenses, DEA registrations, malpractice insurance, board certifications, attestations, and other time-sensitive credentials.
• Keep provider records compliant with Holon Health policies, NCQA standards, CMS requirements, and state and federal regulations.
• Prepare and maintain documentation for audits, accreditation reviews, and payer credentialing requests.

Operational Support and Collaboration

• Support provider and new market expansion efforts.
• Maintain provider rosters and coordinate submissions to participating health plans.
• Respond to credentialing inquiries from providers, health plans, regulatory agencies, and internal stakeholders.
• Manage credentialing inboxes and daily workflows, including approvals, denials, appeals, and payer correspondence.
• Partner with Operations, Leadership, Contracting, and Compliance teams to support shared goals.
• Identify process improvements that increase efficiency, accuracy, and turnaround times.