Manager, Credentialing and Payor Operations

ABOUT USAt Sprinter Health, our mission is to dramatically expand access to healthcare by reimagining the patient experience—delivered at home and powered by technology for scale.
We’re building the technology and clinical services platform to make preventive, connected healthcare accessible for everyone in the US. We deliver hybrid care (in-home + virtual) backed by data products across 15+ states, serving 60%+ of the US population through major health plans and systems.
With 1M+ patients and 92+ NPS, we’re rapidly scaling our impact. Our team of technologists, clinicians, and operators is backed by investors including a16z, General Catalyst, GV, and Accel that have funded companies like Devoted Health, Livongo, Benchling, Stripe, Ramp, Airbnb, Lyft, Instagram, and Databricks.
We have a rapidly growing team of visionary leaders who are passionate about increasing access to care, lowering healthcare costs, and improving outcomes for patients.

ABOUT THE ROLEWe are looking for a Manager of Credentialing & Payor Operations who will help Sprinter Health scale its operations through excellent credentialing/payor enrollment strategies and operational execution.
You should have experience building a credentialing program that can pass a payor’s delegated credentialing standard and strong operational process expertise. Experience in a tech-enabled healthcare startup is preferred, but not required.
As Manager, Credentialing & Payor Operations, you will manage a licensing, credentialing, and enrollment program leveraging in-house and third-party technology platforms, and ensure seamless provider onboarding & payor enrollment operations.
You will report to our General Counsel and work remotely.

WHAT YOU WILL DO

• Build a net new credentialing program that meets NCQA requirements.
• Own, manage & improve licensing, credentialing and payor enrollment operations and workflows to promote efficiency, compliance, accuracy, timeliness and scalability.
• Lead process improvements across credentialing workflows, ensuring alignment with cross-functional teams (Clinical Ops, RCM, Product, and Compliance teams).
• Collaborate with internal stakeholders to drive operational improvements and tech-enabled solutions to streamline credentialing and overall provider onboarding/experience.
• Serve as a key point of contact for payor enrollment-related issues, providing problem-solving expertise and resolution strategies.
• Build and oversee Sprinter’s Advanced Practice Provider collaboration program, using third-party technology and coordinating with in-house clinical teams as well as external providers.
• Support cross-functional initiatives related to provider onboarding and market expansion.
• Identify automation and tooling opportunities to enhance operational efficiency in credentialing & payor enrollment processes.

WHO YOU ARE

• Minimum 5 years’ experience in healthcare operations, credentialing, and/or payor enrollment
• Experience building a credentialing program that can pass a payor’s delegated credentialing standard is preferred
• Leadership or process ownership experience in credentialing and enrollment.
• Experience in a large hospital, health system, tech-enabled healthcare or digital health company is preferred.
• Strong operational expertise with a track record of optimizing workflows, implementing scalable solutions, and improving efficiency.
• Extensive familiarity with payor enrollment processes, provider credentialing, and compliance regulations.
• Experience managing cross-functional projects and working with internal teams to improve provider operations.
• Tech-savvy mindset, with experience leveraging technology to drive process improvements.
• Strong problem-solving skills and the ability to work in a fast-paced, dynamic environment.
• Excellent communication and organizational skills.

WHAT’S IN IT FOR YOU

• Opportunity to build a critical program from the ground up and have a tangible impact on clinical outcomes
• Dynamic, collaborative environment at the intersection of healthcare and innovation
• Competitive salary + equity package
• Medical, dental, and vision plans 100% paid for you and your dependents
• Flexible PTO + 11 paid holidays per year
• 401(k) with match
• 16-week parental leave policy for birthing parent, 8 weeks for all other parents
• Life insurance, plus short and long-term disability coverage
• Professional growth opportunities
• Annual learning stipend

Sprinter Health is an equal opportunity employer. We value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, disability status or other protected classes.

Originally posted on Himalayas