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
Own market growth strategy across priority Medicaid markets.
Lead the evolution of our value proposition for legacy health plan partners and new prospects.
Serve as a strategic bridge between Payor Partnerships and internal teams.
Equip is the leading virtual, evidence-based eating disorder treatment program. They ensure that everyone with an eating disorder can access treatment that works, leveraging evidence-based treatments to empower individuals to reach lasting recovery. Founded in 2019, they're a fully virtual company.
Support multiple health plan partners from implementation through ongoing value delivery.
Serve as intermediary to fairly represent partner interests and needs to internal stakeholders.
Accountable for health plan satisfaction, renewals & expansion opportunities to new markets, states, and lines of business, contract adherence, contract P&L, contract utilization.
Equip is the leading virtual, evidence-based eating disorder treatment program, ensuring everyone with an eating disorder can access effective treatment. Founded in 2019, Equip has been a fully virtual company with a highly-engaged, passionate, and diverse culture.
Own end-to-end provider credentialing and enrollment across Medicaid, Medicare, Medicare Advantage.
Ensure credentialing policies and documentation meet payer and regulatory requirements.
Build and continuously improve credentialing infrastructure, including SOPs and policies/procedures.
Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the healthcare system. They partner with health plans, providers, and community organizations to deliver culturally competent care; they are scaling rapidly across states and populations.
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.
Lead HR operations and compliance workflows for CNA and IHSS onboarding and employment.
Oversee end-to-end onboarding of CNAs and IHSS families in EHR and HRIS systems.
Monitor and track required employment documents and credentials, maintaining complete personnel files.
Abby Care tackles the challenge of family caregiving. They train and employ family caregivers, building a tech-powered, family-first care platform to deliver care and improve health outcomes nationwide, partnering with insurance plans, healthcare providers, and organizations across the country.
Lead one of Rula’s most critical operational functions.
Own end-to-end credentialing and enrollment outcomes.
Partner across the company to ensure providers are credentialed and enrolled accurately, compliantly, and efficiently.
Rula is dedicated to treating the whole person, not just the symptoms and aim to create a world where mental health is no longer stigmatized or marginalized, but rather is embraced as an integral part of one's overall well-being. Rula is a remote-first company that values diversity, equity, and inclusion.
Serve as the subject matter expert in interpreting payer agreements.
Collaborate with the Provider Network Operations team to support the build of standard operating procedures.
Maintain reconciliation trackers to measure contract performance and support audit requests.
Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. They are the largest network of independent primary care in the country, creating value-based contracts across various health plans.
Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications.
Maintain accurate provider profiles on CAQH, NPPES and any other applicable profiles
Complete credentialing applications to add current and new providers to commercial, Medicaid, and Medicare payers
Expressable is a virtual speech therapy practice with a mission to transform care delivery and expand access to high-quality services. They are passionate advocates of parent-focused intervention, serving thousands of clients since their inception in late 2019.
Lead day-to-day ROI and HIM operations, maintaining execution against KPIs.
Monitor operational performance, backlog, turnaround times, and quality metrics.
Drive operational improvements within existing workflows to improve KPI performance.
Grow Therapy is a platform designed to empower therapists and improve patient access to high-quality care. With technology, it connects providers, insurance payors, and patients to make mental healthcare accessible, serving thousands of therapists and clients nationwide.
Develop and execute a comprehensive market access roadmap for Ceribell’s product portfolio.
Lead long-term strategy for new and existing reimbursement pathways.
Build and sustain relationships with Medicare Administrative Contractors (MACs), national and regional commercial payers, Medicaid plans, and integrated delivery networks (IDNs).
Ceribell is a medical technology company focused on transforming the diagnosis and management of patients with serious neurological conditions. The Ceribell System is being used in hundreds of community hospitals, large academic facilities and major IDN's across the country. Our entire team is driven by a shared commitment to transforming the landscape of critical care through our rapid seizure detection technology, come join the movement!
Architect the systems and processes that power Form Health’s patient experience.
Build the infrastructure needed to support growth while preserving clinical quality, efficiency, and empathy.
Drive operational transformation by designing scalable workflows, data-supported resource models, and technology-enabled efficiencies.
Form Health is a virtual obesity medicine clinic delivering multi-disciplinary evidence-based obesity treatment through telemedicine. Founded in 2019, Form Health is a venture-backed innovative startup with an experienced clinical and leadership team.