Ensure timely resolution and completion of payer enrollment.
Streamline processes and workflows for the onboarding department.
Work with internal and external stakeholders to resolve complex provider enrollment issues.
Privia Health collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology.
Coordinate the end-to-end provider enrollment process for physicians, nurse practitioners, and physician assistants joining the medical group.
Prepare and submit enrollment applications to Medicare, Medicaid, and other applicable payers to establish billing privileges.
Maintain accurate provider data within internal systems (e.g., NPPES, PECOS, CAQH, and iCIMS/HRIS) to ensure consistency across platforms.
Curana Health is dedicated to radically improving the health, happiness, and dignity of older adults. They are a national leader in value-based care, serving 200,000+ seniors in 1,500+ communities across 32 states and employing more than 1,000 clinicians plus other professionals.
Execute credentialing and enrollment workflows for new providers.
Maintain accurate provider and practice data in credentialing database.
Complete Medicare revalidations, Medicaid recredentialing, and commercial recredentialing per payer schedules.
Integrated Dermatology is a leading national dermatology practice that acquires and partners with dermatology practices across the United States. The culture at ID is filled with hard-working, dynamic individuals who come together to ensure the success of our partner dermatologists.
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.
Own the eligibility and enrollment product area: ingestion, validation, enrollment lifecycle, payer data integrations, and cross-platform eligibility signals
Build and improve the tools, campaigns, and workflows that drive member activation and engagement — not just data plumbing, but the experiences that turn eligibility into impact
Partner with engineering, operations, payer partnerships, and marketing to deliver compliant, resilient, and extensible solutions
Maven is the world's largest virtual clinic for women and families on a mission to make healthcare work for all. More than 2,000 employers and health plans trust Maven's end-to-end platform to improve clinical outcomes and reduce healthcare costs. Maven has an award-winning culture.
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.
Seamlessly transition clinicians from the credentialing phase into their active onboarding and training workflows.
Guide clinicians through a structured 30/60/90-day success roadmap, ensuring they hit specific productivity and quality milestones.
Constantly audit the onboarding funnel to identify and remove bottlenecks, reducing the "time-to-activation" for new providers.
Wheel Medical Group is a physician-owned professional corporation that serves patients across the United States, evolving the traditional care ecosystem by equipping the nation's most innovative companies with a premier platform to deliver high-quality virtual care at scale. They offer proven strategies and cutting-edge technologies to foster consumer engagement, build brand loyalty, and maximize return on investment.
Manage and maintain accurate provider credentialing files and profiles.
Support Clinical Operations including Provider communications.
Coordinate full-cycle credentialing, re-credentialing, and insurance contracting.
SimpliFed is focused on providing maternal health services. The company appears to be a startup with a focus on innovation and improving women’s health.
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.
Own and maintain a centralized payer rulebook across all health plans.
Interpret payer requirements and translate them into clear operational workflows.
Own performance outcomes at the health plan level (KPIs, compliance, documentation).
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 and are scaling rapidly across states and populations.
Manage the credentialing and re-credentialing processes for physicians, nurses, and allied health professionals.
Verify licenses, certifications, education, training, and work history to ensure providers are fully qualified.
Maintain accurate and complete credentialing files, ensuring all staff are cleared before providing care.
Curana Health focuses on improving the health, happiness, and dignity of older adults. They are a national leader in value-based care, with over 1,000 clinicians serving 200,000+ seniors across 32 states.
Evaluate facility credentialing applications for accuracy and completeness.
Engage with facilities to clarify credentialing-related questions and obtain missing information.
Update and maintain credentialing software systems with necessary facility information.
Curana Health is dedicated to radically improving the health, happiness, and dignity of older adults. They are a national leader in value-based care, serving 200,000+ seniors in 1,500+ communities across 32 states, with a team of more than 1,000 clinicians and professionals.
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.
Own the full implementation process from contract signing to post-launch stabilization, developing customized launch plans.
Educate frontline care staff on Meela’s value and how to champion it with residents and families.
Track adoption metrics and act on findings, flagging issues early and working cross-functionally to resolve them.
Meela builds phone-based AI tools for older adults and their caregivers, addressing loneliness and caregiver burnout. They are backed by tier-one venture capital and live in senior living communities across the U.S., with a focus on scaling responsibly and improving the product in partnership with users.
Act as a "scouter" for the executive team, taking high-level goals and executing them from start to finish.
Personally design, configure, and deploy AI agents and automated workflows using systems such as Microsoft Copilot Studio or Power Automate.
Train staff on the tools you build and iterate based on their direct feedback.
Ennoble Care is a mobile primary care, palliative care, and hospice service provider with patients in multiple states. They provide continuum of care for those with chronic conditions and limited mobility, striving to provide the highest quality of care by a team patients know and trust.