Manager, Licensing & Contracting

We are seeking an experienced, detail-oriented, and proactive Manager, Licensing & Contracting to join our team.  This role will manage and streamline the corporate licensing and agent onboarding, licensing, and contracting processes.  If you have a proven track record in managing state registration, corporate licensing, and agent onboarding, this is your opportunity to leverage your expertise and make a significant impact in a collaborative, innovative environment.  

Key Responsibilities

Licensing Compliance:

• Obtain and maintain required licenses for TPA operations across multiple states and jurisdictions.
• Ensure compliance with federal, state, and local regulations related to healthcare administration.
• Agent Licensing Management: facilitate the application, renewal, and maintenance of agent licenses across multiple states, ensuring adherence to regulatory requirements.

Renewals and Filings:

• Manage timely license renewals to avoid lapses or disruptions in operations.
• Prepare, submit, and track license applications and related filings with regulatory agencies.

Regulatory Research:

• Monitor changes in laws, regulations, and guidelines affecting TPAs.
• Provide guidance to the organization on compliance requirements and adjustments needed to maintain licensing.

Documentation and Recordkeeping:

• Maintain a centralized database of all corporate licenses, permits, and certifications.
• Ensure accurate recordkeeping for audits, inspections, and internal reviews.
• Contracting Coordination: oversee the agent contracting process, including drafting, reviewing, and executing contracts, and maintaining a comprehensive database of agreements.

Cross-Departmental Coordination:

• Work with legal, compliance, and operations teams to address licensing requirements.
• Collaborate with insurance carriers, brokers, and partners on compliance needs.

Audit and Reporting:

• Support internal and external audits related to licensing and regulatory compliance.
• Generate reports and summaries for management on licensing status and potential risks.

Process Optimization:

• Agent Support: serve as the primary point of contact for agents, addressing inquiries related to licensing, contracting, and compliance in a timely manner.
• Identify and implement improvements to licensing workflows and processes.
• Establish best practices to streamline license acquisition and renewal.

Qualifications

Education

• Bachelor’s degree in business administration, law, healthcare management, or a related field (preferred).

Experience

• Prior experience in licensing, compliance, or regulatory affairs in healthcare or insurance industries.
• Familiarity with TPA operations and applicable regulations.

Skills

• Strong organizational and project management abilities.
• Knowledge of healthcare regulations (e.g., HIPAA, ACA) and licensing processes.
• Proficiency in research, documentation, and data management systems.
• Excellent communication and analytical skills.

Key Attributes:

• Detail-oriented with the ability to handle multiple licensing requirements simultaneously.
• Strong ethical standards and commitment to maintaining regulatory compliance.
• Adaptability to changes in regulatory environments and industry practices.

This role is critical in ensuring the TPA operates legally and efficiently, enabling smooth delivery of administrative services in the healthcare sector.