About the Opportunity

As the Provider Credentialing and Payer Enrollment Manager, you will be an integral part of the Operations team at Found. In this key leadership role, you will be responsible for overseeing and driving all internal processes related to provider credentialing and payer enrollment.  You will collaborate with external licensing and credentialing partners to ensure Found’s provider network meets compliance and regulatory standards, and is ready to deliver both in-network and direct to consumer care and services in a timely fashion.  In addition, your work will directly impact the financial health and operational efficiency of the organization, playing a pivotal role in our ability to sustain and grow our patient base.

In this role, your expertise in provider credentialing and payer enrollment will be crucial in supporting our revenue cycle and expanding our provider networks. This position offers the exciting opportunity to make a tangible difference in both our operational success and in the lives of the patients we serve, by ensuring seamless access to our healthcare services.

What You’ll Do

• Provider Credentialing:
• Initiate and manage the initial provider credentialing process for new providers, ensuring accurate and timely collection of the required documentation
• Collaborate with external licensing and credentialing partner(s) to enter and verify all necessary information for the completion of credentialing applications
• Payer Enrollment:
• Work with our external partner(s) to ensure the timely submission of initial and re-credentialing applications with various insurance payers
• Liaise with external partner(s) and insurance companies to resolve issues related to enrollment and credentialing
• Compliance and Quality Control:
• Ensure compliance with all state and federal regulations regarding provider credentialing and licensure
• Ensure visibility into the status of credentialing and enrollment processes through the creation of internal report and/or through leveraging external partner(s) reporting capabilities
• Work with Operations leadership and external partner(s) to achieve and maintain delegated credentialing privileges 

What You’ll Bring 

• 2+ years credentialing experience
• 3+ years of experience processing multiple payer enrollment applications at a time
• Demonstrated knowledge and experience with healthcare regulations, accreditation standards, including NCQA credentialing policies and procedures for delegated credentialing, and general payer requirements
• Adaptable self-starter comfortable working in a fast paced, growth phase startup
• Clear written and verbal communicator with excellent attention to detail, organization, and prioritization skills
• Proficient in using credentialing software, Gsuite and/or Office applications, and Slack
• Bachelor's degree in healthcare administration, business, or a related field preferred.
• Certification in Provider Credentialing (CPCS or CPMSM) is a plus

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