Senior Manager, Credentialing and Enrollment

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November 26

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Brightside Health

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Healthcare Insurance • Wellness • SaaS

Brightside Health is an online mental health service provider that offers personalized care for individuals experiencing anxiety, depression, PTSD, bipolar disorder, and more. They provide both therapy and psychiatric services, including medication management, through a virtual platform. Brightside takes a personalized approach with 1:1 support, quick access to licensed professionals, and a focus on measurable results. Their innovative offerings include a Crisis Care program specifically for individuals with a high risk of suicide. The service is designed to be accessible and is covered by insurance, providing convenient mental health care options for patients aged 13 and up.

51 - 200 employees

⚕️ Healthcare Insurance

🧘 Wellness

☁️ SaaS

📋 Description

• Leverage your experience in behavioral health provider credentialing to develop, manage and monitor processes, policies and procedures that support the credentialing and re-credentialing processes of providers. • Interface with CAQH, insurance company credentialing leaders, provider services, human resources and operations to ensure a smooth credentialing process including, but not limited to: CVO performance monitoring • Managing report generation • Provider communication (as needed) • Committee set-up and provider credentials approval process and tracking • Delegation audit coordination • Primary source verification (PSV) tracking • Communication with payers regarding delegated credentialing requirements • Oversee the payer enrollment stage with health plans. Experience interacting with health plan counterparts and familiarization with the health plan landscape is a requirement. • Oversee all aspects of the Credentialing Review Committee, including scheduling meetings, ensure documentation preparation, meeting notes, etc in partnership with the CVO. • Prepare Brightside to be a delegated credentialing entity through the development of policies and procedures. • Prepare for and coordinate credentialing audits in compliance with managed care credentialing contracts. • Coordinate with clinical operations and onboarding as it relates to credentialing, re-credentialing and provider access.

🎯 Requirements

• Depth of experience in Credentialing Leadership • Start-up experience is highly valued • Excellent communication skills, both written and verbal • Deep and experienced knowledge of delegated credentialing • Creative problem-solver, flexible thinking, and ability to meet deadlines with accuracy in work • Highly organized and detail-oriented • Experience leading a credentialing team and excellent people management skills

🏖️ Benefits

• Fully paid for comprehensive health care (medical, dental, vision) • Pet Insurance • Life Insurance & Short / Long Term Disability • 401k Plan • Unlimited PTO and sick leave • Parental Leave • Work remotely and whatever schedule works best for you • Additional memberships and perks