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.
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.
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.
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.
Guide the Care Partner Team, ensuring efficient completion of monthly programs and fostering a positive environment.
Assist management by identifying and addressing areas of need within the CCM/RPM process.
Support hiring and training, using training programs effectively to ensure all team members excel.
Medsien is revolutionizing healthcare with its cutting-edge remote care management solutions. They aim to enhance patient outcomes through seamless integration of technology, allowing healthcare providers to deliver exceptional care with ease.
Review and process applications in all DOHMH license applications and all relevant information.
Mange the day to day operations of the unit.
Supervise staff, including tracking and assigning tasks, to ensure productivity and effectiveness, conducting training and providing guidance
The NYC Department of Consumer and Worker Protection (DCWP) is the nation’s leading municipal enforcement agency charged with delivering economic justice. They license more than 45,000 businesses and provide essential services such as free tax preparation and financial counseling.
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 licensed telesales agents selling Medicare Advantage policies.
Provide live coaching, call shadowing, and immediate feedback to drive sales and maintain quality and compliance.
Manage day-to-day operations and resolve issues to protect the member experience.
Devoted Health's mission is to dramatically improve the health and well-being of older Americans by caring for every person like family. Founded in 2017, they've grown fast and now serve members across the United 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.
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.
Help scale and execute a community-oriented primary care model.
Lead the team responsible for eligibility list outreach, inbound patient call support, and scheduling operations.
Oversee daily operations, performance metrics, quality assurance, and workflow optimization.
Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the one-size-fits-all healthcare system. Founded in 2021, Zócalo Health is backed by leading healthcare and mission-aligned investors and is scaling rapidly across states and populations.
Manage complex provider roster creation, submission, and record reconciliation.
Oversee resolution of moderate-scope issues by prioritizing tasks.
Serve as main contact for roster inquiries, collaborating with internal teams and external payers.
Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Supervise a team of appeals and grievances coordinators; develop/implement strategies to improve team performance and efficiency.
Receive, document, and manage member and provider appeals and grievances in accordance with Dignity Health MSOs policies and standards. Prepare and present reports on appeals and grievances activity.
Maintain detailed and accurate records of all appeals and grievances, including documentation of investigations, outcomes, and communications.
Dignity Health MSO offers management and business services that leverage economies of scale across provider types and geographies, leading the effort in developing Dignity Health’s Medicaid population health care management pathways. They focus on coordinating patient care while containing costs and improving quality of service. The company offers a Total Rewards package that integrates competitive pay with flexible Health & Welfare benefits and a generous employer-matched 401k retirement plan.
Oversee strategic and operational aspects of the enterprise telephony and telecom portfolio.
Lead and manage the telephony support team, providing mentorship and development.
Ensure telephony services support new market launches and meet business expectations.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care, enhancing existing teams with compassion and commitment.
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.
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.
Oversee day-to-day operations of the facility to meet State and Federal regulations.
Supervise all department managers to ensure the facility is in compliance.
Ensure customer service while facilitating the resolution of resident care issues.
Tutera Senior Living & Health Care aims to live the YOUNITE philosophy in every decision, every day, emphasizing respect and personalized care for residents and team members. Founded in 1985, it is a family-owned company which offers stability, competitive wages, and benefits, while also growing and developing its employees.