USAManager, Credentialing & Payer Operations
3 дн. назад
USAMiddleRemote
Responsible for managing credentialing and payer operations to support healthcare provider enrollment and payer-side processes.
Обязанности
- Allara is expanding our footprint and volume rapidly, and Payer Operations is the engine that keeps us growing, enrollment, credentialing, and the payer-side processes that let clinicians see patients. The Manager of Credentialing and Payer Operations runs that engine day to day: it owns the throughput, quality, and reliability of payer operations as volume scales, and builds a team that can absorb that growth without a proportional increase in headcount or manual work.
- Location: Hybrid (NYC) or Remote. We value in-person collaboration and aim for at least three days per week in our NYC office, with flexibility as needed.
Требования
- 5+ years of experience in high growth operations, with a preference for direct exposure to provider credentialing, licensing and payer enrollment
- Demonstrated ability to build and improve operational systems in a fast-moving, resource-constrained environment
- Process-obsessed and detail-oriented: you see inefficiency and can't help but fix it
- Strong analytical skills: comfortable pulling data, identifying trends, and translating insights into operational decisions
- Excellent cross-functional communicator, able to work across teams and move things forward without direct authority
- Genuinely excited by automation, tooling, and AI. You see technology as a force multiplier, not a threat
Будет плюсом
- Experience in telehealth or multi-state provider network operations
- Hands-on experience with payer portals and third party portals i.e. Availity
- Familiarity with commercial payer requirements (Understanding Medicare and Medicaid processes is a plus)
- Experience in multi-state telehealth, digital health, or a high-growth healthcare environment
- Exposure to credentialing standards (e.g., NCQA, CMS)
Другое
- Allara is a comprehensive women’s health provider that specializes in expert, longitudinal care that supports women through every life stage. Trusted by over 60,000 women nationwide, Allara makes expert healthcare accessible by connecting patients with multidisciplinary care teams that have a deep understanding of hormonal, metabolic, and reproductive care. Allara provides ongoing support for hormonal conditions like PCOS, chronic conditions like insulin resistance, and life stages like perimenopause, helping patients see improved health outcomes . As one of the fastest-growing women’s health platforms in the U.S., Allara is bridging long-overlooked gaps in healthcare for women.
- Build and strengthen structures to ensure providers are credentialed in a timely and compliant manner; work to automate and optimize this process and ensure a fast and high quality provider experience
- Administer our Credentialing Committee, collaborating with clinical leadership to enforce guidelines, provide timely review of files, and coordinate provider applications
- Own relationships with our credentialing/CVO vendors to monitor and improve SLA performance
- Own day-to-day provider data maintenance and the architecture to support all credentialing and licensing needs at scale
- Serve as the subject matter expert with provider enrollments with health plans; developing relationships with key contacts and documenting/embedding the enrollment processes/SOPs within the team workflows
- Design quality controls and error-catching checkpoints that reduce rework and rejected applications
- Ensure the team documents updates meticulously
- Actively monitor team performance and SLAs, flagging aging items and escalations quickly to identify and solve root cause issues before they become systematic problems
- Coach and lead a team of US based and international specialists
- Coordinate cross-functionally with RCM, payer strategy/ business development teams to investigate and solve root cause problems in our payer and claims cycles and in our national expansion efforts
- Train new team members to be successful and productive members of the team quickly
- Set and enforce performance standards across the team
- Work with product, engineering and other teams to design automations and AI based flows that make the team more efficient in delivering consistent quality work
- Compensation & Career Growth $90,000-$100,000 with opportunities for advancement
- Equity
- Professional development & employee learning programs
- Actual compensation will be determined based on a variety of factors, including but not limited to: candidate experience, location, education, certifications, and skill set. In addition to base salary, our total compensation package includes equity, comprehensive health benefits (medical, dental, vision), generous paid time off, and additional wellness and professional development perks.
- Work Environment & Flexibility 3-day hybrid in NYC or fully remote
- Unlimited PTO & 11 company holidays
- Health & Wellness Medical, dental, and vision benefits
- Health Savings Account (HSA) & Flexible Spending Account (FSA)
- Long- and short-term disability coverage
- Annual employee wellness stipend
- Family & Future Planning 401(k) plan
- Parental leave & family planning support benefits
- Additional Perks Company-issued laptop
- Annual work-from-home stipend
- Commuter benefits (if applicable)
- A collaborative, mission-driven culture focused on improving patient care
- At Allara , we believe in celebrating everything that makes us human and are proud to be an equal-opportunity workplace. We embrace diversity and are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We believe that the more inclusive we are, the better we can serve our members. We’re an Equal Opportunity Employer and do not discriminate against candidates or patients based on race, color, gender, sexual orientation, gender identity or expression, age, religion, disability, national origin, protected veteran status, or any other status protected by applicable federal, state, or local law.