Execute payer enrollment applications from credentialing approval through payer confirmation.
Coordinate CAQH profile maintenance and attestations in alignment with Medallion workflows and payer requirements.
Track enrollment status, follow up with payers, and escalate delays or issues to the Payer Enrollment Manager.
Spring Health aims to eliminate barriers to mental health by delivering the right care at the right time through their clinically validated technology, Precision Mental Healthcare. They partner with over 450 companies and are valued at $3.3 billion.
Responsible for economic credentialing and provider enrollment with contracted managed care and governmental plans.
Communicating provider participation information to internal and external customers.
Ensures compliance with regulatory agencies and maintains a working knowledge of statues and laws.
The West Virginia University Health System is West Virginia’s largest health system and the state’s largest employer. They have more than 3,400 licensed beds, 4,600 providers, 35,000 employees, and $7 billion in total operating revenues.
Manage all aspects of provider licensing, credentialing, and payer enrollment.
Coordinate end-to-end licensing workflows and maintain accurate records.
Act as a key liaison between clinicians, state boards, payers, and internal stakeholders.
They are committed to providing safe, discreet medication abortion treatment and offer a range of reproductive and sexual health care services. The in-house clinical care team composed of board-certified doctors, advanced practice clinicians, nurses, and patient care advocates, is just a text message away.
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.
Own the end-to-end cycle of credentialing applications for new and existing providers under our contracts, ensuring all requirements are met for successful enrollment.
Assist in building NCQA compliant ongoing monitoring and delegation programs for the Nourish network of RDs.
Support efforts to streamline existing credentialing processes by providing suggestions for automation or new tools, optimizing individual steps, and ensuring smooth workflows.
Nourish is on a mission to improve people’s health by making it easy to eat well. They are building an AI-native, patient-friendly healthcare system centered on nutrition that improves outcomes, lowers costs, and helps people live healthier, longer lives. Nourish launched three years ago, are live in all 50 states, and already have thousands of dietitians and hundreds of thousands of patients on the platform.
Prepare and submit credentialing and enrollment packets.
Maintain accurate provider files and track expirations.
Provide assistance to the billing team during staff absences.
Modena Health and Modena Allergy & Asthma are leading medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona and plans for national expansion. They are physician-led and technology-enabled, committed to transforming allergy care while advancing clinical research and expanding access to cutting-edge medicine.
Lead negotiations for hospital and health system contracts.
Prepare contracts, amendments, and rate analyses.
Coordinate with internal departments for contract compliance.
Arizona General focuses on providing healthcare services. The company seems to have a supportive work environment focusing on collaboration, as suggested by the benefits mentioned.
Lead payor contract implementations, requiring both internal and external cross-functional stakeholder management
Drive revenue cycle issue resolutions (claims processing, credentialing), which includes coordination with payors and internal operations teams
Spearhead cross-functional strategic initiatives that have an impact on revenue (implementation of new product/service lines, as an example)
Ophelia is a venture-backed healthcare startup that provides medication and clinical care through a telehealth platform to help individuals with OUD (opioid use disorder). They are a team of physicians, scientists, entrepreneurs, researchers and White House advisors working to re-imagine and re-build OUD treatment in America.
Managing key partnerships: Building trusted relationships with large payors and complex partners, serving as their go-to contact.
Collaborating on new agreements: Partnering closely with our Sales team to negotiate and launch new contracts—especially Value-Based Care programs.
Tracking and improving results: Keeping a close eye on partner performance metrics and incentive outcomes.
Grow Therapy's mission is to serve as the trusted partner for therapists growing their practice, and patients accessing high-quality care. Powered by technology, they are a three-sided marketplace that empowers providers, augments insurance payors, and serves patients. Since launching in February 2021, Grow Therapy has empowered more than ten thousand therapists and hundreds of thousands of clients across the country and insurance landscape.
Lead negotiations for new and existing payor agreements.
Develop negotiation strategies informed by market dynamics and data analysis.
Collaborate with cross-functional partners to ensure contracts can be operationalized effectively.
SonderMind provides personalized mental health care, encompassing therapy, medication management, and mindfulness exercises. They leverage digital tools and research to deliver high-quality care and develop thriving practices, combining technology and human connection to drive better outcomes.
Conduct coverage reviews based on member plan benefits and policies.
Document clinical review findings, actions, and outcomes.
Communicate and collaborate with providers for benefit determinations.
Capital Blue Cross promises to go the extra mile for their team and community. They foster a flexible environment where health and wellbeing are prioritized and employees consistently vote it as one of the "Best Places to Work in PA."
Lead the design, expansion, and optimization of the organization’s provider network to achieve strategic goals.
Manage the end-to-end network application and contracting lifecycle, including negotiation of terms and contract execution.
Monitor legislative, regulatory, and industry trends to proactively inform and adjust the organization’s network strategy.
Foodsmart is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Through their personalized, digital platform, they guide their 2.2 million members on a tailored journey to eating well while saving time and money. At Foodsmart, their mission is to make nutritious food accessible and affordable for everyone, regardless of economic status. They are committed to measured, impactful, collaborative, hungry and joyful core values.
Own Payor channel bookings and revenue targets — with accountability for both new logo acquisition and strategic account expansion.
Build and manage a high-velocity pipeline focused on top TPAs, health plans, networks, and payor aggregators.
Define and execute the Payor go-to-market strategy, including ICP, value proposition, sales motions, and pricing structure.
Nomi Health delivers disruptive healthcare solutions, in partnership with like-minded employers, public sector organizations, advisors (brokers/consultants), and payers/TPAs. They are a team of 300+ people who show up every day with the same mindset: don’t settle for “that’s just how it is.
Source & vet engineers, finding and engaging senior full-stack engineers and product managers.
Hire physicians, nurse practitioners, and dietitians experienced in weight management and metabolic health.
Represent LumiMeds as a top-tier destination for both tech and medical talent.
LumiMeds is a fast-growing U.S.-based telehealth company focused on weight management and long-term metabolic health. We work with a fully remote, globally distributed team and pride ourselves on moving quickly, communicating clearly, and building systems that actually work.
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.
Set and execute Medicare agency strategy, partnering with the GM of Healthcare and Strategy & Ops to define a 3-year plan, annual OKRs, and a GTM strategy that drives 5–7x enrollment growth by 2026
Build and scale the brand and growth engine, partnering with Marketing to establish the agency brand and drive top-of-funnel demand across digital, advisor-assisted, and partner channels
Lead cross-functional operations and execution, aligning product, operations, and growth roadmaps while scaling efficiently through automation and AI
Propel empowers low-income Americans by simplifying access to government benefits with modern technology. They are a passionate team of 100 Propellers, all working to help their users get through the month, every month.
Manage licensure, certification, and credentialing for all applicable staff.
Track expiration dates and renewal requirements for licenses, certifications, DEA registrations, NPI numbers, and professional credentials.
Ensure compliance with state boards, CMS, accrediting organizations, and payer requirements.
Brighton/Suncrest Hospice aims to redefine hospice care by delivering outstanding service to patients. They achieve this by allocating resources to improve staff-to-patient ratios, increasing clinical visits, and lowering clinician caseloads. They are CHAP certified.
Showcase customer service and data entry skills as part of the healthcare team.
Involved in claims adjudication and/or provider credentialing.
Support customers by phone, email and chat.
Sutherland helps customers globally achieve greater agility and transform automated customer experiences. As a digital transformation company they have been in business for over 35 years and are Great Place to Work certified with nearly 40,000 employees.
Review, draft and negotiate complex healthcare partnership and government contract deals.
Counsel and advise stakeholders on legal issues impacting the business.
Build and refine internal transactional processes, policies, and tools that can scale efficiently with company growth
Oura's mission is to empower every person to own their inner potential. Their award-winning products help their global community gain a deeper knowledge of their readiness, activity, and sleep quality by using their Oura Ring and its connected app. They're a quickly growing company focused on helping people live healthier and happier lives, and they ensure that their team members have what they need to do their best work — both in and out of the office.
Serve as a key account manager for assigned vendors.
Manage vendor utilization including workflows for coordinating services.
Track, analyze, and report on vendor performance and opportunities for improvement.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.