Senior Specialist, Payer Operations

Summary

Join Spring Health as a Payer Operations Specialist and contribute to our mission of eliminating barriers to mental healthcare. Reporting to the Senior Program Manager, you will develop expertise in payer partner operations, supporting new payer launches and expanding existing businesses. This role involves data analytics to monitor performance, project management to ensure timely implementation, and documentation to maintain compliance. You will collaborate with various stakeholders and leverage your analytical, project management, and communication skills. This is a full-time remote position with occasional travel. Spring Health offers a competitive total rewards package including stock options and comprehensive benefits.

Requirements

• Bachelor's degree in Business, Finance, Healthcare Administration, Operations Management, or related field
• 3+ years of experience in process engineering, analytics, and healthcare operations
• Strong understanding of industry standards and regulatory requirements
• Excellent project management and problem-solving skills
• Exceptional technical writing skill with the ability to translate complex information to concise, easy-to-reference resources
• Strong communication and interpersonal skills, with the ability to collaborate effectively with cross-functional teams
• Ability to work independently and manage multiple priorities in a fast-paced environment
• Resilience and a solution-focused mindset to thrive autonomously in constantly changing and ambiguous hyper-growth environments

Responsibilities

• Analyze clinical, operational, and financial data to monitor payer operations' health and performance
• Identify root causes of clinical, operational, and financial issues and risks
• Provide visibility into strategic opportunities for payer operations
• Monitor and report on process performance, quantifying efficiency gains and identifying areas for further improvement
• Identify implementation requirements, risks, and milestones
• Ensure project deliverables remain on track; escalate, and identify potential risks
• Keep internal and external business stakeholders informed and engaged
• Define clear project deliverables and criteria for success to meet project launch timelines
• Document Payer Operations requirements, workflows, and SOP to ensure clarity, consistency, and regulatory compliance
• Develop and maintain a robust internal knowledge base for Payer Operations and cross-functional partners, proactively updating documentation as needed
• Coordinate with cross functional leaders to review documentation and align workflows

Preferred Qualifications

• PMP or CAPM certification
• Experience using SQL, Snowflake, and Looker
• Experience with analytics, data modeling, and architecture
• Experience with financial modeling
• Knowledge of healthcare data standards (X12 837, 276/277, 835, 270/271, etc.)
• Experience with process improvement, including Lean Six Sigma methodologies
• Experience working with or for a health plan

Benefits

• Health, Dental, Vision benefits start on your first day at Spring
• You and your dependents also receive access to One Medical accounts HSA and FSA plans are also available, with Spring contributing up to $1K for HSAs, depending on your plan type
• Employer sponsored 401(k) match of up to 2% for retirement planning
• A yearly allotment of no cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents
• We offer competitive paid time off policies including vacation, sick leave and company holidays
• At 6 months tenure with Spring, we offer parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents
• Access to Noom , a weight management program—based in psychology, that’s tailored to your unique needs and goals
• Access to fertility care support through Carrot , in addition to $4,000 reimbursement for related fertility expenses
• Access to Wellhub ,  which connects employees to the best options for fitness, mindfulness, nutrition, and sleep in one subscription
• Access to BrightHorizons , which provides sponsored child care, back-up care, and elder care
• Up to $1,000 Professional Development Reimbursement a year
• $200 per year donation matching to support your favorite causes