Manager, Payer Integrations

August 27

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Spring Health

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Healthcare Insurance • Wellness • SaaS

Spring Health is a comprehensive mental health solution designed for employers and health plans. It utilizes Precision Mental Healthcare to deliver personalized mental health support by matching individuals with the right care, whether it's digital support, meditation exercises, coaching, therapy, or medication. By partnering with leading organizations, Spring Health aims to improve mental health accessibility and outcomes, reduce employee turnover, and enhance productivity. Trusted by over 4,500 organizations, the company provides an evidence-based approach that has been proven to deliver positive clinical and financial results.

501 - 1000 employees

⚕️ Healthcare Insurance

🧘 Wellness

☁️ SaaS

📋 Description

• Oversee Spring Health’s payer integration portfolio—own performance for the CSN book of business, lead a team of Payer Integration Managers, and drive high-quality, on-time integrations with health plans and TPAs. • Build cross-functional processes that accelerate implementations, reduce DSO, and increase clean-claim rates while acting as a trusted partner to internal teams and external payer contacts. • Own a portfolio of payer integrations, driving clean claims, faster payments, and improved accuracy across systems. • Set and achieve key metrics including clean-claim rate, denial reductions, DSO, and launch timelines. • Lead and grow a team of Payer Integration Managers, fostering clarity, development, and accountability. • Prioritize and resource a high-impact pipeline of integrations and escalations based on business risk and revenue. • Manage end-to-end payer launches—requirements, testing, and workflows across EDI, benefits, portals, and more. • Identify and resolve barriers in claims logic, provider data, and configuration to ensure seamless adjudication. • Partner across Billing, Benefits, Legal, and more to create repeatable playbooks and system-wide solutions. • Build and evolve a payer KPI dashboard to monitor and optimize performance. • Represent Spring Health with payers, building strong relationships and aligning on implementation and operations. • Drive automation, tooling, and process improvements to reduce manual work and accelerate cycle time. • Lead special projects as needed, translating learnings into scalable, evergreen practices. • Success measures include consistent on-time launches, revenue-cycle impact improvements (clean-claim rate, DSO, denial reduction), team performance and operational maturity, and cross-functional trust.

🎯 Requirements

• 5+ years of relevant experience in payer integrations/relations, healthcare implementation, or RCM within payer/provider ecosystems. • 2+ years of experience directly managing a team, with demonstrated success in coaching, developing talent, and driving team performance in a fast-paced, cross-functional environment. • Expert knowledge of payer operations and claims adjudication, including benefit design, funding structures, eligibility, and payment workflows. • Hands-on expertise with HIPAA/ EDI (837, 835, 270/271), clearinghouses, payer portals, roster/CAQH workflows, EFT/ERA. • Demonstrated success leading integration projects end-to-end—planning, execution, testing, launch—with measurable KPI improvements (DSO reduction, denial reduction, clean-claim success). • Advanced analytical and problem-solving skills; ability to identify integration risks and craft innovative mitigation strategies. • Exceptional communication and stakeholder management across technical and non-technical audiences; adept at presenting findings to senior leadership. • Nice to have: Bachelor’s degree in Health Information Management Systems (HIMS) or related field; Certified EDI Professional (CEP) or similar credentials. • Nice to have: Experience with behavioral health, multi-state provider networks, and regulatory/compliance standards. • Nice to have: Familiarity with Looker/BI, workflow tools (Asana/Jira), and integration platforms (e.g., Apero or similar).

🏖️ Benefits

• Health, Dental, Vision benefits start on your first day at Spring. You and your dependents also receive access to One Medical; 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.