Spring Health is hiring a
Senior Manager

Summary

Join our mission to revolutionize mental healthcare by removing every barrier that prevents people from getting the help they need, when they need it. We're seeking a Senior Manager of Credentialing and Compliance to oversee all aspects of credentialing/recredentialing of practitioners in alignment with State, Federal, and NCQA standards.

Requirements

• Minimum of 7 years of experience in a quality-focused role in healthcare, with a strong emphasis on provider credentialing, provider data integrity, and managing provider network adequacy within a health plan setting
• Demonstrated experience in developing policy and procedure documentation
• Knowledge of NCQA Accreditation requirements and demonstrated experience preparing for and leading accreditation and regulatory 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, and professionalism
• Demonstrated passion for, and understanding of, mental health and the broader U.S. healthcare system

Responsibilities

• Oversee all aspects of the credentialing/recredentialing of practitioners in alignment with State, Federal, and NCQA standards
• Manage and ensure quality related to credentialing operations
• Work cross-functionally with Product, Health Plan Operations, Medical Affairs, and Compliance teams to pull and analyze reports
• Act as the Subject Matter Expert (SME) for credentialing processes and systems
• Establish, implement, and monitor performance goals, metrics, and processes for the Credentialing department
• Lead the implementation of new credentialing tools and systems to enhance operational efficiency and compliance
• Oversee provider enrollment processes, including the submission, tracking and follow-up of applications
• Maintain familiarity with network adequacy and provider network standards to ensure compliance with regulatory and contractual requirements
• Manage provider data by conducting regular audits to ensure the accuracy and integrity of provider information in credentialing databases and systems
• Collaborate closely with the Revenue Cycle Management (RCM) team to ensure that provider credentialing and enrollment statuses are up-to-date
• Provide strong leadership and development opportunities to the credentialing team, fostering a collaborative and high-performance culture

Benefits

• Health, Dental, Vision benefits start on your first day at Spring Health
• Individual One Medical account which is valued at $199/year per user
• A yearly allotment of no cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents
• 10 allocated sick days per year
• Flexible paid time off in addition to 12 paid holidays throughout the year
• Access to Gympass, an on-demand virtual benefit that provides wellbeing coaching, and budget management
• Spring Renewal: When you hit your four-year Springaversary, you’ll be awarded a four-week, fully-paid sabbatical leave to renew and recharge
• 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 fertility care support through Carrot, in addition to $4,000 reimbursement for related fertility expenses