Oversee daily operations and performance of Provider Enrollment Specialists.
Monitor team performance against standards and address gaps.
Provide coaching and development to strengthen team capability.
EnableComp provides specialty revenue cycle management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability. They are a multi-year recipient of the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years.
Coordinate the end-to-end medical provider enrollment process.
Prepare and submit enrollment applications to Medicare, Medicaid, and other payers.
Maintain accurate provider data within internal systems to ensure consistency.
Curana Health is dedicated to radically improving the health, happiness, and dignity of older adults through value-based care. Founded in 2021, it has quickly grown to serve over 200,000 seniors in 1,500+ communities across 32 states with a team of 1,000+ clinicians and other professionals.
Enrolling practitioners in health plans in a timely and effective fashion.
Monitoring progress and ensuring timeliness of enrollment completion.
Maintaining provider enrollment goals for all divisions.
Pediatrix Medical Group provides specialized health care for women, babies, and children. Since 1979, Pediatrix has grown into a national, multispecialty medical group committed to coordinated, compassionate, and clinically excellent services.
Submit accurate enrollment applications to multiple public and private payers.
Manage enrollments across multiple states and provider types, ensuring timely follow-up.
Maintain up-to-date provider information in CAQH and resolve enrollment discrepancies.
Seven Starling is a virtual provider of women's behavioral health services, supporting every stage of motherhood. They combine therapy, peer support, and medication management with 94% of patients seeing improvement. They partner with OBGYN clinics and health plans to make care accessible.
Define and execute the long-term vision for credentialing and enrollment, transitioning from manual processes to a tech-enabled, scalable operation.
Oversee the end-to-end enrollment process for Medicare, Medicaid, and Commercial payers. Be the primary liaison for enterprise contract activations.
Lead the internal Credentialing Committee, presenting provider files and ensuring all primary source verifications (NPDB, OIG, SAM) are flawless.
Foodsmart is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Their platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. At Foodsmart, their mission is to make nutritious food accessible and affordable for everyone, regardless of economic status.
Own the end-to-end credentialing and payer enrollment process for behavioral health providers across multiple states.
Manage internal credentialing onboarding for newly hired providers by collecting and validating required documentation.
Design and maintain credentialing and enrollment tracking systems to monitor application status, renewal timeliness, and enrollment milestones as the company scales.
Willow Health aims to significantly improve the mental health care experience by expanding affordable access to high-quality, evidence-based intensive behavioral health care. The co-founding team of Cityblock and Oscar alums has two decades of collective experience working in healthcare and healthcare tech, and they are backed by Andreessen Horowitz.
Lead and develop a team of Payer Enrollment Coordinators and Specialists.
Manage and improve the systems that help support the team’s processes.
Medallion provides a provider operations platform to eliminate administrative bottlenecks. They are ranked No. 3 on Inc. Magazine’s 2024 Fastest-Growing Private Companies in the Pacific Region and have $130M in funding.
Manage the end-to-end process of licensing applications.
Coordinate the initial credentialing and re-credentialing processes for licensed providers.
Maintain accurate and up-to-date records of all licensing and credentialing activities.
InStride Health delivers specialty anxiety and OCD care. They combine research-backed clinical care and innovative technology to eliminate the major problems with care today, and become the nation’s most trusted provider of pediatric anxiety and OCD care.
Execute non-delegated credentialing process for new and existing providers.
Serve as a point of contact for all insurance payor relationships.
Maintain accurate and up-to-date records of all credentialing activities.
Dental Care Alliance's mission is to advance the practice of dentistry by partnering with and supporting dental professionals to create a lifetime of healthy smiles. Headquartered in Sarasota, Florida, DCA supports over 400 allied practices and supports over 900 dentists across over 20 States.
Responsible for the direct supervision of the centralized managed care activities.
Leads the team by recruiting, training, mentoring, and managing the work queues of direct reports.
Serves as the first line of communication with the practices/departments to answer questions and trouble shoot issues.
OHSU is Oregon's only public academic health center. In addition to caring for patients, they lead groundbreaking research and train the next generation of health care professionals. As Portland's largest employer, OHSU provides opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington.
Manage the standard credentialing review process for pharmacies.
Review exclusion lists to identify any excluded pharmacies.
Manage the development and maintenance of a credentialing database.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They have solutions such as Capital Rx and Judi® which consolidates all claim administration-related workflows in one scalable, secure platform.
Supervise daily operations of the Medical Staff Office, ensuring efficient workflow and timely completion of credentialing activities.
Provide oversight for credentialing, privileging, and medical staff administrative processes in compliance with regulatory and accreditation standards.
Support medical staff meetings and committees, and maintain the integrity of the credentialing database.
Hillsboro Medical Center is part of OHSU, Oregon's only public academic health center, which cares for patients, leads groundbreaking research, and trains healthcare professionals. As Portland's largest employer, it is a system of hospitals and clinics across Oregon and Southwest Washington striving to be an anti-racist, multicultural institution.
Conduct outreach calls to practices, and build immediate rapport and trust by adapting approach to their needs
Lead individual and group practice meetings to build successful workflows with the Stellar application and drive performance on key outcomes
Quickly triage inbound emails and answer questions from practices
Stellar Health helps primary care providers put patient health first with their technology platform, people, and analytics. They are a US-based Health-tech backed by Top VCs with an established product & proven operating model.