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.
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.
Manage provider enrollment & credentialing, leading the credentialing lifecycle for new and existing providers and practice locations.
Maintain provider data, ensuring CAQH profiles are complete, current, and accurately reflect provider credentials and practice information.
Optimize workflows, assessing current credentialing processes, identifying inefficiencies, and implementing improvements.
Sailor Health aims to solve the mental health crisis among older adults by connecting them, therapists, healthcare professionals, and insurance plans through their AI-native operating system. They are a growing company partnered with Medicare, offering affordable psychotherapy and striving to redefine aging with mental wellness.
Lead, coach, and develop a team of Ops Associates.
Oversee the design and implementation of payor builds or process improvements.
Work closely with the Managers to identify process breakdowns and implement solutions.
Grow Therapy aims to be the trusted partner for therapists growing their practice, and patients accessing high-quality care. They are a three-sided marketplace that empowers providers, augments insurance payors, and serves patients, and have empowered more than ten thousand therapists and hundreds of thousands of clients across the country.
Follows documented process to ensure timely processing of Primary Source Verification completion for initial and recredentialing.
Follows guidelines in alignment with all NCQA, CMS, and state requirements as related to the provider credentialing.
Works with both internal and external stakeholders to resolve complex provider credentialing issues.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers
Assisting with provider credentialing by collecting documentation, entering provider data, submitting required materials to the health plan, tracking completion, and updating internal records.
Maintaining and updating provider records from various sources in internal systems to ensure accuracy and completeness.
Supporting reporting requirements, including completing health plan reports on assigned schedules.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. They aim to make healthcare affordable, improve patient health, and restore fulfillment in practicing medicine for providers. Powered by AI and Healthguides™, Guidehealth builds connections with patients and providers.
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.
Stand up and run the daily clinical operations for PIN/CHI delivery.
Define the care team structure, supervision ratios, and operating cadence.
Ensure billing-ready documentation is completed correctly every time. Partner with Compliance + RCM support to prevent leakage/denials caused by ops errors.
Carewell is focused on providing the most trusted and reputable retail source for caregiving products. They have been recognized as one of the fastest-growing companies in the US.
Oversee provider credentialing, provider licensing, payer contracting, and network expansion.
Lead end-to-end provider credentialing, provider licensing and recredentialing for MDs and NPs.
Manage relationships with credentialing and contracting vendors.
Sunrise Group is building the future of sleep health by combining innovative technology with expert care. They are a fast-growing team across the US and Europe, backed by more than $50M (€46M) from leading investors including Amazon’s Alexa Fund, Eurazeo, Kurma, and VIVES.
Lead day-to-day census, enrollment, eligibility, and Medicaid re-eligibility operations.
Develop, maintain, and enforce department policies, procedures, workflows, and monitoring routines.
Supervise, mentor, and develop staff while setting clear expectations and maintaining accountability for performance and quality.
Habitat Health aims to help older adults experience an independent and joyful aging journey. They provide clinical and social care through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with healthcare partners like Kaiser Permanente.
Support the Medical Staff Services Credentialing team.
Collect, verify, and maintain accurate records within the Credentialing system.
Perform other administrative duties as assigned.
Cooper University Health Care is committed to providing extraordinary health care. Their professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.
Manage end-to-end provider contracting and credentialing processes.
Maintain accurate and up-to-date provider records and documentation.
Assist with billing setup for newly credentialed providers.
Understood Care helps older adults by providing them with Medicare-covered patient advocacy services. They pair each person with a dedicated advocate who helps them navigate care, reduce costs, and make confident healthcare decisions.