Partner with cross functional leaders to ensure internal processes and care delivery are in accordance with health plan needs across commercial and Medicaid lines of business
Translate health plan contracts, provider manuals, and regulatory requirements into scalable operational workflows
Serve as the internal subject-matter expert on credentialing and payor operational requirements
Equip is a virtual, evidence-based eating disorder treatment program. They aim to provide accessible and effective treatment. Founded in 2019, Equip has been a fully virtual company and has a highly-engaged, passionate, and diverse culture.
Establish and monitor performance metrics to measure the reliability and latency of payer data feeds.
Serve as the primary point of escalation for high-priority payer data issues, coordinating with various teams.
Oversee the documentation and submission processes for clinical data extracts to ensure audit readiness.
Aledade empowers independent primary care practices to deliver better patient care and thrive in value-based care. As the largest network of independent primary care in the country, they focus on creating value-based contracts, strengthening care continuity, and aligning incentives to ensure physicians are paid for keeping patients healthy.
Zócalo Health is a tech-enabled primary care organization that focuses on serving underserved populations by partnering with health plans, providers, and community organizations to deliver culturally competent care. Founded in 2021, they combine local teams with virtual care and technology to deliver whole-person care and are rapidly scaling across states and populations.
Build and lead Zócalo Health’s prior authorization function.
Design and implement scalable processes for authorization intake, submission, tracking, and follow up.
Hire, develop, and manage a team responsible for authorization operations.
Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the one-size-fits-all healthcare system. Founded in 2021, Zócalo Health is backed by leading healthcare and mission-aligned investors and is scaling rapidly across states and populations.
Own full P&L responsibility, including forecasting, budgeting, and performance reporting.
Build and develop a high-performing, mission-driven team.
Propel builds technology that strengthens the social safety net in America. They aim to improve how government benefits are delivered and have grown revenue 35% YoY, serving over 5.5 million Americans.
Provide direct supervision, coaching, and performance oversight to clinical managers.
Serve as a primary operational liaison between clinical teams and health plan care management teams.
Oversee onboarding and training for care teams and clinical managers.
Tuesday Health is a value-based palliative care provider group dedicated to transforming serious illness and end-of-life care. They deliver goal-centered care focused on alleviating physical symptoms and emotional stress for individuals and their caregivers. They cultivate a dynamic and inclusive team environment.
Own the end-to-end performance of the claims operation.
Drive claims quality, speed, and scalability through inventory management.
Develop the claims department's client experience strategy.
Centivo is an innovative health plan for self-funded employers. They are on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills and work with employers ranging in size from 51 employees to Fortune 500 companies.