Manager, Credentialing & Payer Operations

🔥 12 minutes ago

🗽 New York, Texas – Remote

🗽 New York – Remote 🤠 Texas – Remote

💵 $90k - $100k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

👻 Ghost score 20%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Allara

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2020

💼 Consulting

🛡️ Insurance

🏥 Healthcare

💰 $26M Series B - Allara on 2025-01

Consulting • Insurance • Healthcare

<Allara> Allara is a telehealth women’s specialty care platform that provides personalized, team-based medical and nutrition care for complex hormonal, metabolic, and gynecological conditions. Through virtual visits, board-certified OB-GYNs, endocrinologists, nurse practitioners, registered dietitians, and care concierges, Allara delivers comprehensive testing, individualized treatment plans, and ongoing monitoring, with insurance-supported or self-pay options.

📋 Description

• Build and strengthen structures to ensure providers are credentialed in a timely and compliant manner • Automate and optimize credentialing processes and ensure a fast, high-quality provider experience • Administer the Credentialing Committee and collaborate with clinical leadership to enforce guidelines and review files • Coordinate provider applications • Own relationships with credentialing/CVO vendors and monitor and improve SLA performance • Own provider data maintenance and architecture supporting credentialing and licensing needs at scale • Serve as subject matter expert for provider enrollments with health plans • Develop relationships with key payer contacts and document and embed enrollment processes/SOPs • Design quality controls and error-catching checkpoints to reduce rework and rejected applications • Ensure meticulous team documentation • Monitor team performance and SLAs, flag aging items, and resolve root-cause issues • Coach and lead US-based and international specialists • Coordinate with RCM, payer strategy, and business development teams on payer, claims, and national expansion issues • Train new team members • Set and enforce team performance standards • Collaborate with product, engineering, and other teams to design automation and AI-based workflows

🎯 Requirements

• 5+ years of experience in high growth operations, with a preference for direct exposure to provider credentialing, licensing and payer enrollment • Demonstrated ability to build and improve operational systems in a fast-moving, resource-constrained environment • Process-obsessed and detail-oriented • Strong analytical skills: comfortable pulling data, identifying trends, and translating insights into operational decisions • Excellent cross-functional communicator, able to work across teams and move things forward without direct authority • Genuinely excited by automation, tooling, and AI • Experience in telehealth or multi-state provider network operations preferred • Hands-on experience with payer portals and third party portals, e.g. Availity, preferred • Familiarity with commercial payer requirements preferred; understanding Medicare and Medicaid processes is a plus • Experience in multi-state telehealth, digital health, or a high-growth healthcare environment preferred • Exposure to credentialing standards such as NCQA and CMS preferred

🏖️ Benefits

• Equity • Professional development & employee learning programs • Comprehensive health benefits (medical, dental, vision) • Unlimited PTO & 11 company holidays • Health Savings Account (HSA) & Flexible Spending Account (FSA) • Long- and short-term disability coverage • Annual employee wellness stipend • 401(k) plan • Parental leave & family planning support benefits • Company-issued laptop • Annual work-from-home stipend • Commuter benefits (if applicable) • Opportunities for advancement • A collaborative, mission-driven culture focused on improving patient care