Manager, Credentialing

We are looking for a Manager, Credentialing to oversee the operations of Spring Health’s provider credentialing department, manage and monitor procedures that support credentialing, recredentialing, data management, and delegated credentialing contract processes.  Partnering closely with Onboarding, Quality, Compliance, Legal, and Medical Affairs, the Manager, Credentialing will ensure compliance with appropriate accrediting and regulatory agencies and be responsible for the quality and performance of the credentialing team.  This position will have 3 direct reports and will report to the Associate Director, Provider Experience.

What you’ll be doing:

• Oversee all aspects of the credentialing/recredentialing of practitioners in alignment with NCQA standards. Responsible for pre-delegated and annual audits of all credentialing delegated entities. 
• Manage all activities and ensure quality related to credentialing operations, and provide oversight to ensure the continued growth and development of the organization.
• ​​Responsible for the management of the Credentialing Department: establishing, implementing, and monitoring performance goals, metrics, and processes for the Credentialing department. Prepare and maintain various reports, data, and summaries of credentialing activities.
• Review and manage provider credentialing processes to ensure that policies/workflows are followed in compliance with State, Federal, and NCQA guidelines as well as contracted health plan directives.
• Prepare credentials files for presentation to committees and partners within established deadlines. Support Credentialing meetings on an ongoing basis; coordinating meeting times, schedules, developing agenda and presenting necessary documents for review with the relevant committees.
• Accountability for delegated oversight, including performing pre-delegation and annual audits to ensure compliance with the delegated credentialing agreements and regulatory standards

What we expect from you:

• 5 years of experience in a quality focused role in healthcare, including significant experience in provider credentialing/recredentialing
• Demonstrated experience in developing policy and procedure documentation
• Knowledge of NCQA Accreditation requirements and demonstrated experience preparing for and leading regulator site surveys (NCQA, TJC, CMS, etc.)
• Knowledge of medical credentialing and privileging procedures and standards
• Experience in project management and partnering with cross functional teams
• Data-driven and analytical by nature with demonstrated skills in gathering, analyzing, and interpreting data in Google Sheets/MS Excel 
• Excellent oral and written communication skills — ability to fluently tell a compelling clinical, compliance, or business story with data
• A thoughtful and collaborative approach to problem solving 
• Humility, resourcefulness, empathy, professionalism

• Demonstrated passion for, and understanding of, mental health and the broader U.S. healthcare system 

Preferred

• NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS)
• CPHQ, CPPS, CPHRM or similar certification
• Experience leading regulatory and audit/survey preparation (TJC, NCQA, Payers, etc.) and net new quality accreditation efforts
• Experience selecting, implementing, and managing new software systems

The target salary range for this position is $97,700-114,500, and is part of a competitive total rewards package including stock options, benefits, and incentive pay for eligible roles. Individual pay may vary from the target range and is determined by a number of factors including experience, location, internal pay equity, and other relevant business considerations. We review all employee pay and compensation programs annually at minimum to ensure competitive and fair pay.

Don’t meet every requirement? Studies have shown that women, communities of color and historically underrepresented talent are less likely to apply to jobs unless they meet every single qualification. At Spring Health we are dedicated to building a diverse, inclusive and authentic workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we strongly encourage you to apply. You may be just the right candidate for this or other roles!

Ready to do the most impactful work of your life? Learn more about our values, how we work, and how hypergrowth meets impact at Spring Health: Our Values

What to expect working here:

• You will be held accountable to an exceptionally high bar and impact
• This may be the fastest work environment you will ever experience in terms of growth, decision-making, and time to impact
• You will be challenged to set and protect your own boundaries
• You will create processes & products that have never existed before
• You will have very direct conversations and receive continuous feedback to push you to become the highest performer you can be
• Change is a constant here: your role, team, responsibilities, and success metrics will shift as the company grows

And…

• You get to be surrounded by some of the brightest minds in the field  
• You get to learn and grow at an extremely accelerated pace
• You will experience transparency, integrity, &  humility from leadership 
• You will be empowered to constantly challenge the status quo
• You get the space to experiment & innovate
• You get to make a transformational impact for the company, mental health, and for real human lives — and you will see that impact quickly
• You will become more resourceful and resilient
• You get to be part of a winning team that opens doors in the future

Benefits provided by Spring Health:

Your Total Health:

• Generous medical, dental, vision coverage available day 1 + access to One Medical
• 20 total yearly no-cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents
• Flexible paid time off in addition to 12 paid holidays throughout the year
• $500 per year Wellness Reimbursement
• Access to Gympass, an on-demand virtual benefit that provides wellbeing coaching, and budget management.
• Spring Health provides access to QuitGenius, a platform with technology-tailored, personalized addiction treatment plans for substance use (*QG is available to benefit-enrolled employees, spouses, and dependents age 18+)
• Sabbatical Leave: When you’re a Team Member at Spring Health and hit your four-year Springaversary, you’ll be awarded a four week, fully paid, sabbatical leave. 

You And Your family:

• 4-4.5 months of fully paid parental leave
• Spring Health provides team members and their families with sponsored access to Bright Horizons® child care, back-up care, and elder care.
• Access to Joshin is provided by Spring Health. Joshin is a comprehensive support system for disabilities and neurodivergence in the workplace. This benefit supports employees, their families, and our teams through personalized navigation and disability education and training along with a network of screened in-home caregivers with disability and neurodivergent experience. 
• Access to fertility care support through Carrot, in addition to $4,000 reimbursement for related fertility expenses

Supporting you financially through:

• Our People team benchmarks all salaries using the Radford Global Compensation Database for technology and life sciences industries. Radford benchmarks salaries with 3,589 global firms, 6.5 million employees, and 98 countries across the globe. We do this to ensure all of our team members are paid equally and competitively.
• On top of competitive and benchmarked salary, Spring Health offers incentive pay (based on role), and equity that begins vesting as we celebrate your first year with the company!
• Employer sponsored 401(k) match of up to 2% after 90 days of employment

Creating a culture you can thrive in:

• Flexible work arrangements: 60% of Spring Health team members work fully remote while 40% work in a hybrid model from our New York City offices
• Focus Fridays: no meetings, no distractions, just time for you to get work done.
• Focus Weeks: In Spring 2023, we held our first ever Focus Week, we canceled all non-essential meetings, minimized distractions, and you, our team members, to dive into the key work that gets chopped up or deprioritized during the regular day-to-day. We saw a 36% jump in the average energized score after those five days of flow state work and are finalizing a plan for quarterly Focus Weeks for team members.
• Up to $1,000 Professional Development Reimbursement per calendar year.
• $200 per year donation matching to support your favorite causes