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operational workflows operations data reporting credentialing medicaid📋 Description
- Lead operational infrastructure for payor partnerships across commercial and Medicaid.
- Translate contracts, provider manuals, and regulatory requirements into scalable workflows.
- Act as internal SME on credentialing and payor operational requirements.
- Oversee credentialing to ensure timely, compliant enrollment across all payors.
- Collaborate with Care Delivery, Revenue Cycle, Legal to ensure readiness.
- Drive data insights and KPIs to optimize payor performance.
🎯 Requirements
- 8+ years in payor operations, managed care, or healthcare administration.
- Experience with commercial health plans and Medicaid regulatory/compliance.
- Proven leadership managing operational teams in fast-paced environments.
- Strong cross-functional collaboration with clinical and operational stakeholders.
- Healthcare startups or high-growth experience preferred.
- Ability to translate complex contracts and regulations into executable workflows.
🎁 Benefits
- Flex PTO 3-5 weeks/year + 11 holidays.
- Generous parental leave.
- Comprehensive medical, dental, vision, life, and AD&D insurance.
- Spring Health employer-paid mental health benefit (and dependents).
- Home office stipends and equipment (internet, coworking space, laptop).
- 401K option and related benefits.
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