Senior Manager, Strategic Credentialing and Network Operations

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $105k - $115k / year

⏰ Full Time

🟠 Senior

🌐 Network Operations

👻 Ghost score 20%

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Blackbird Health

WebsiteLinkedInAll Job Openings

1 - 10 employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Blackbird Health is a mental health practice dedicated to assisting kids and young adults with social, developmental, and school-related challenges. For nearly a decade, Blackbird Health has been eliminating the trial and error from diagnosis and treatment to achieve faster and more effective outcomes. It offers a virtual-first model with optional in-person care, providing quick service through personalized assessments, diagnoses, and treatments. The practice specializes in addressing issues such as anxiety, depression, ADHD, autism, and more, utilizing a comprehensive range of therapies and support systems.

📋 Description

• Own multi-state provider enrollment across commercial and Medicaid/MCO plans, reducing provider ramp time from offer acceptance to billing activation • Direct third-party credentialing vendors, establishing KPIs, SLAs, and accountability structures to prevent onboarding backlogs • Build, maintain, and operationalize health plan delegated credentialing arrangements • Lead NCQA/MCO audit preparedness • Partner with RCM, Clinical Ops, Legal, and Tech to optimize provider roster management, EHR data integrations, and billing alignment • Report directly to the SVP of Finance • Serve as the credentialing engine owner across Finance, Clinical Ops, RCM, and Tech

🎯 Requirements

• 8+ years of healthcare credentialing and provider enrollment experience (multi-state behavioral/mental health preferred) • Proven track record managing delegated credentialing processes and health plan audit requirements • Hands-on experience managing third-party vendors against SLAs • Strong command of NCQA standards and Medicaid/MCO rules • Deep knowledge of health plan delegation audits and MCO/Medicaid regulatory requirements • Experience analyzing operational bottlenecks, tracking provider-to-payer ramp metrics, and automating workflows • Proven success building collaborative relationships with health plan network directors, internal executive stakeholders, and external vendors • Certified Provider Credentialing Specialist (CPCS) or CPCS-MS preferred

🏖️ Benefits

• Medical, Dental & Vision coverage • 401(k) with company match • Employer-paid life insurance • Generous paid time off • Diverse, experienced leadership team and supportive culture