Manager, Credentialing and Payor Operations

Summary

Join Sprinter Health as their Manager of Credentialing & Payor Operations and help scale their operations through excellent credentialing/payor enrollment strategies and operational execution. You will build a net new credentialing program, manage licensing, credentialing, and payor enrollment operations, and lead process improvements across credentialing workflows. Collaboration with internal stakeholders to drive operational improvements and tech-enabled solutions is crucial. You will serve as a key point of contact for payor enrollment issues and build Sprinter’s Advanced Practice Provider collaboration program. This role requires strong operational expertise, familiarity with payor enrollment processes, and experience managing cross-functional projects. The position offers a competitive salary, equity, and comprehensive benefits.

Requirements

• Minimum 5 years’ experience in healthcare operations, credentialing, and/or payor enrollment
• Leadership or process ownership experience in credentialing and enrollment
• 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

Responsibilities

• 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

Preferred Qualifications

• Experience in a large hospital, health system, tech-enabled healthcare or digital health company is preferred
• Experience building a credentialing program that can pass a payor’s delegated credentialing standard is preferred

Benefits

• 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