Lead the strategy to secure national payor agreements, moving from state-by-state enrollment to national in-network contracts with major commercial payors.
Manage a Credentialing Specialist, setting SLAs and KPIs for credentialing turnaround time, while overseeing payor enrollment and claim denial resolution.
Partner with Clinical Ops and Revenue Cycle to align provider onboarding with credentialing lead times and national agreement rollouts.
Own the licensing vendor relationship and budget, directing vendor performance and holding them accountable.
Manage payer credentialing end to end, ensuring providers are enrolled and revenue-ready.
Own payer roster management and develop relationships with payer representatives to resolve issues.
Brightline provides pediatric behavioral health care via virtual and in-person services, including therapy and psychiatry for kids up to age 18. Founded in 2019, the company has served tens of thousands of families and is nationally recognized for clinical excellence.
Manage provider credentialing and enrollment processes to ensure compliance with NCQA, URAC, Joint Commission, CMS, and state regulations.
Oversee a team of specialists, monitor KPIs like "Days to Enroll," and resolve complex application rejections to protect cash flow.
Collaborate with Compliance, Billing, Legal, and Clinical teams to troubleshoot credentialing-related claim denials and maintain database accuracy.
Sleep Doctor is a trusted sleep health company helping millions get better rest through clinical expertise and consumer-first experiences. They foster a collaborative, growth-oriented culture where every team member contributes to bold solutions.
Manage end-to-end provider credentialing and payer enrollment processes across multiple states.
Ensure compliance with government and commercial payer requirements to minimize claim denials.
Serve as a subject matter expert, supporting team training and process improvements.
The company operates a nationwide virtual healthcare network, focusing on transforming cardiovascular care delivery. The team is mission-driven and values innovation, collaboration, and continuous improvement.
Build, document, and maintain end-to-end SOPs for payer contracting, enrollment, and credentialing workflows.
Design quality controls and error-catching checkpoints that reduce rework and rejected applications.
Conduct persistent, proactive follow-up with payers to push applications through to approval.
Allara is a comprehensive women's health provider that specializes in expert, longitudinal care for women through every life stage. Trusted by over 60,000 women nationwide, Allara is one of the fastest-growing women's health platforms in the U.S., bridging gaps in healthcare for women.
Serve as the single point of accountability for all payor relationships, contracts, and negotiations across an assigned regional portfolio.
Own the full contract management and modeling function, including fee schedule updates, performance monitoring, and financial modeling.
Develop and execute a regional payor strategy aligned with enterprise growth targets and net revenue goals.
Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments with over 70 clinics across 8 states. We are building the future of vein care with a Net Promoter Score of 93, the highest patient satisfaction in the industry.
Oversee the processing of initial payer applications to ensure compliance with accreditation standards and regulations.
Maintain and manage payer credentialing databases with accuracy and audit readiness.
Supervise payer credentialing staff by coordinating workloads, providing training, and monitoring performance.
Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care. They serve facilities across the United States, offering multispecialty physician services, telemedicine, and remote patient monitoring.
Manage end-to-end payer enrollment for providers across commercial, Medicare, and Medicaid health plans.
Support provider licensing operations including new applications, renewals, and compliance activities.
Collaborate with internal teams and external partners to ensure timely credentialing and minimize patient care delays.
Oshi Health is a virtual digestive health practice transforming GI care by combining compassionate, multidisciplinary care with innovative technology. The company is a remote-first, mission-driven startup focused on revolutionizing how chronic digestive conditions are diagnosed and managed, with a culture emphasizing respect and inclusion.
Lead the full credentialing and recredentialing process for W-2 clinicians across multiple states and payer networks.
Develop and maintain credentialing policies aligned with NCQA, CMS, and state-specific guidelines.
Partner with recruiting, clinical operations, legal, and finance to ensure efficient onboarding and regulatory compliance.
Headlight is a mental healthcare company founded by psychiatrists, transforming access to care and delivery methods for clinicians. They are a growing organization with a collaborative culture, focusing on innovation and whole-person care.
Lead managers and supervisors responsible for member enrollment and billing operations.
Drive achievement of client SLAs, quality metrics, productivity, and financial targets.
Partner with clients and internal stakeholders to identify operational improvements and foster a culture of accountability.
Sutherland leverages artificial intelligence, automation, and cloud engineering to drive digital transformation for iconic brands. With over 200 patents and a focus on human-machine collaboration, the company delivers measurable results through a seamless 'as a service' model.
Manage, negotiate, and optimize payer agreements to execute the company's payer contracting process strategy.
Sit at the intersection of revenue cycle management, payer relations, and organizational growth with technical expertise in managed care contracting.
Collaborate with internal teams across business development, clinical operations, legal, and finance to manage payer relationships with precision.
Connections Health Solutions is a leading provider of immediate-access behavioral health crisis care, combining medical and recovery-oriented treatment to stabilize individuals in crisis and connect them to community resources. Founded by emergency room psychiatrists, our physician-led, data-driven model has served hundreds of thousands of individuals and is recognized as a national best practice by SAMHSA and the National Council for Mental Wellbeing.
Submit and track provider enrollments across Medicare/Medicaid and commercial payers to secure effective dates.
Maintain CAQH attestations and accurate provider data across payer portals and internal credentialing systems.
Assist with onboarding new providers and respond to payer requests to resolve application issues.
Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. With over 70 clinics across 8 states and a Net Promoter Score of 93, they are committed to compassionate, patient-first care.
Oversee end-to-end health plan enrollment process and manage vendor performance.
Ensure accurate and timely processing of enrollment requests while maintaining compliance with SLAs.
Act as subject matter expert in payer enrollment requirements and resolve enrollment delays.
Medallion is a healthcare technology company that automates licensing, credentialing, and compliance monitoring for healthcare organizations. It is one of the fastest-growing healthcare technology companies, ranked #3 on Inc. Magazine's 2024 Fastest-Growing Private Companies in the Pacific Region and a Glassdoor Best Place to Work in 2024 & 2025.
Coordinate and monitor provider/facility payer credentialing and re-credentialing processes.
Send, review, and verify credentialing applications and maintain provider information in online database.
Track license and certification expirations and ensure timely renewals for medical staff.
Bozeman Health is a healthcare organization dedicated to caring for the communities of Southwest Montana. They foster a Culture of Excellence emphasizing high performance, transparent communication, and continuous learning.
Design and launch credentialing workflows, quality standards, and operational processes from the ground up.
Manage the complete credentialing lifecycle including payer enrollment, CAQH management, and compliance monitoring.
Recruit, train, and lead credentialing specialists to scale the service while maintaining accuracy and reliability.
This partner company specializes in healthcare credentialing and revenue cycle management. They offer a dynamic, globally distributed team culture with a focus on efficiency and compliance.
Acts as the execution engine of the U.S. HEMA organization, serving as the primary tactical interface with providers, payers, and field teams.
Develops value dossiers, manages payer advisory boards, generates billing guides, and supports coding implementation logistics.
Serves as the primary point of contact for customer reimbursement vendor management and coordinates field personnel for payer campaigns.
Intuitive is a global leader in robotic-assisted surgery and minimally invasive care, driven by a nearly 30-year mission to make surgery less invasive and recovery less painful. We are a team of engineers, clinicians, and innovators united by one purpose: to make surgery smarter, safer, and more human.
Directs and governs the entire self-pay vendor ecosystem, including coverage discovery and bad debt collections.
Develops vendor strategy, SLAs, KPIs, and leads quarterly business reviews with key vendors.
Builds and mentors a high-performing team of analysts, ensuring workflow excellence and compliance.
Ventra is a leading business solutions provider for facility-based physicians in anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, they partner with private practices and health systems to deliver data-driven solutions, and as a large enterprise with a robust rewards program, they emphasize a collaborative culture.
Own a payer revenue target and build a pipeline of national and regional health plans.
Articulate the value of Abridge's platform to payer executives, including risk adjustment and quality measures.
Develop territory and account plans, penetrate new payer accounts, and expand existing relationships.
Abridge is an AI-powered platform that transforms patient-clinician conversations into structured clinical notes in real-time, powered by generative AI. The company is a growing team of MDs, AI scientists, and engineers, with a culture of extreme ownership and empathy.
Manage patient-facing and internal billing questions, including resolving denials and processing insurance verifications.
Work claims end-to-end with cross-functional stakeholders to ensure smooth billing experiences.
Support efforts to streamline existing processes by suggesting automation and maintaining reliable execution.
Nourish is an AI-native digital health system that matches patients with registered dietitians, physicians, and medications for insurance-covered metabolic health care. They have completed millions of appointments, tripled year-over-year, and partner with health plans covering 200M+ Americans, with a culture of high talent density and relentless resilience.
Lead the execution of market access and reimbursement strategies for biologics and rare disease therapies.
Develop and maintain executive-level relationships with national payer stakeholders to negotiate high-impact agreements.
Provide strategic insights on payer trends and competitive dynamics to shape commercial strategy.
Dr. Reddy's is a global pharmaceutical company dedicated to making medicines affordable and discovering innovative treatments to help people lead longer, healthier lives. The company fosters a culture of empathy, dynamism, and inclusion, valuing diverse perspectives and teamwork.
Lead a team of payer sales executives to achieve revenue, renewal, and retention objectives within the payer market segment.
Develop and execute payer-focused sales strategies, foster strong relationships with payer stakeholders, and drive market expansion.
Collaborate with cross-functional teams and utilize AI-enabled tools to enhance sales effectiveness and ensure sustainable revenue growth.
MCG leads the healthcare community to deliver patient-focused care with a mission-driven team of talented physicians and technical experts developing evidence-based content and innovating products. They are part of Hearst, with over 100 years of experience, and offer a dynamic work environment with world-class benefits.