Insurance Directory Optimization Specialist

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🇺🇸 United States – Remote

⏳ Contract/Temporary

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Legion Health

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2021

⚕️ Healthcare Insurance

🧘 Wellness

💰 Seed Round on 2024-09

Healthcare Insurance • Wellness • Mental Health

Legion Health is a provider of world-class psychiatric care, making mental health services accessible to everyone. With a team of board-certified providers and guided by top psychiatric experts, Legion Health offers a tailored, affordable approach to mental wellness. Their services include comprehensive evaluations, personalized follow-up schedules, and coordination with other members of the care team, all provided through a secure telemedicine platform for convenience and comfort.

📋 Description

• Own Legion’s provider-directory accuracy and growth metrics across every contracted payer and network, state, clinician, service location, specialty, and member-facing directory surface. • Build and maintain the authoritative provider-data source of truth, including clinician legal and display names, Type 1 and Type 2 NPIs, group affiliations, taxonomy codes, licenses, specialties, service locations, telehealth eligibility, accepting-new-patients status, contact information, booking URLs, payer participation, last verification date, owner, status, and supporting evidence. • Reconcile the source of truth against NPPES, CAQH, credentialing rosters, payer portals, third-party aggregators, and internal provider and contracting systems; define source precedence for every field so discrepancies are resolved consistently. • Create a complete baseline inventory and risk-ranked remediation backlog, prioritizing missing providers, inactive or departed providers, wrong locations, missing telehealth indicators, incorrect specialties, duplicate records, broken links, phone-only calls to action, and high-volume payer opportunities. • Audit each directory as a patient would: search by ZIP code, state, plan, specialty, telehealth, availability, and accepting-new-patients filters; confirm Legion appears in the expected results and that every profile is accurate, complete, and actionable. • Verify that telehealth filters, virtual-visit tags, map pins, specialty mappings, language fields, appointment availability, and accepting-new-patients indicators behave correctly across desktop and mobile directory experiences where available. • Submit corrections through the right payer workflow—portal, roster file, API, secure email, ticket, or escalation—and track submission date, confirmation number, payer owner, promised service level, follow-up date, publication date, and member-side verification. A fix is not complete until it is live and independently rechecked. • Standardize naming conventions, address formatting, phone numbers, credentials, taxonomy and specialty mappings, group affiliations, telehealth designations, and URL structure; build validation rules and an explicit exception log. • Partner with payer directory and network-operations teams to improve Legion’s legitimate search prominence through accurate category mapping, telepsychiatry and virtual-care terminology, featured or virtual-visit badges, complete profile fields, and correct filter eligibility. • Replace phone-only or generic calls to action with direct Legion landing pages, self-scheduling links, or SMS short codes wherever payer rules and directory capabilities allow. • Create and govern unique UTM-tagged links by payer, network, directory, state, and placement; maintain a durable naming convention, redirect ownership, destination QA, and documentation so attribution survives future updates. • Partner with Growth and Engineering to build payer- and state-aware landing experiences, align insurance and availability messaging, reduce intake abandonment, and A/B-test calls to action, trust signals, scheduling flows, and page content. • Instrument and validate the directory funnel in PostHog or equivalent analytics from directory referral through eligibility, intake, scheduling, completed first visit, retention, and reactivation; maintain event definitions and investigate attribution gaps. • Build weekly reporting that covers inventory completeness, percentage of error-free listings, search-visibility coverage, corrections opened and closed, aging by payer, clicks, intakes, scheduled visits, completed visits, conversion rates, and attributable revenue. • Quantify the incremental patient volume and revenue unlocked by each material directory fix; maintain an opportunity model that ranks the backlog by expected impact, confidence, effort, and time to resolution. • Establish monthly sweeps and lightweight automated monitoring that detect payer regressions, roster drift, broken URLs, status changes, duplicate records, and unexpected search-result changes before they cost patients or revenue. • Integrate provider launches, departures, license changes, new payer contracts, new states, address changes, taxonomy updates, and scheduling changes into a documented change-management workflow with clear owners and service levels. • Create payer contact maps, escalation paths, reusable outreach templates, roster-submission checklists, evidence standards, SOPs, and a decision log so the operating system is auditable, repeatable, and transferable.

🎯 Requirements

• 2+ years in provider-data management, payer or network operations, credentialing, revenue-cycle operations, healthcare data quality, growth operations, or a closely related role. • Direct experience updating payer directories, provider-finder tools, or network rosters through platforms such as Availity, CAQH, HealthSmart, payer-specific portals, delegated roster workflows, or third-party directory vendors. • Strong working knowledge of Type 1 and Type 2 NPIs, NPPES, CAQH ProView, taxonomy codes, specialties, group affiliations, service locations, telehealth designations, accepting-new-patients status, and network participation. • Experience diagnosing discrepancies across multiple systems, determining the authoritative source, documenting the root cause, and verifying the member-facing correction after publication. • Advanced comfort with Google Sheets or Excel, including large CSVs, XLOOKUP or VLOOKUP, INDEX-MATCH, pivot tables, data validation, deduplication, conditional formatting, normalization, and reconciliation. • Comfort with lightweight SQL, APIs, JSON or XML, SFTP roster files, scripts, or no-code automation; you do not need to be a software engineer, but you should be able to remove repetitive work. • Experience with UTM conventions, redirect QA, PostHog or comparable product analytics, funnel reporting, and conversion-rate measurement. • Ability to operate across portals, spreadsheets, email, phone, ticketing systems, and ambiguous payer processes while maintaining precise evidence and follow-up discipline. • Strong written and verbal communication. You can write a clean escalation, ask a payer representative for the exact file or field definition needed, and explain the patient and revenue impact of an unresolved issue. • Excellent quality-control instincts. You notice one transposed digit, inconsistent taxonomy mapping, outdated address, missing virtual-care tag, or suspicious duplicate—and you investigate until the record is correct. • Sound healthcare and privacy judgment. You can work with provider and network data while respecting access controls, minimum-necessary practices, payer rules, and Legion’s compliance requirements. • Low ego, high urgency, and end-to-end ownership. You measure success in accurate live listings and completed visits, not activity, submitted forms, or closed spreadsheets.

🏖️ Benefits

• Performance Bonus: Additional compensation tied to strong outcomes such as verified listing accuracy, correction cycle time, directory-sourced booked visits, and measurable revenue impact • Contract Structure: Independent contractor (1099) • Time Commitment: Approximately 20–40 hours/week • Initial Term: 3-month project, renewable based on results and business needs • Work Hours: Flexible, with planned overlap for U.S. payer and internal-team coordination • Work Setup: Remote • Tools: PostHog, analytics dashboards, Google Sheets or Airtable, payer portals, CAQH, NPPES, roster files, APIs, and automation tools • Impact: Every accurate, discoverable listing helps a patient find in-network psychiatric care faster and turns an invisible operations fix into measurable clinical and business value. • Growth Opportunities: As the program scales, this engagement can expand into broader provider-data governance, payer operations, credentialing systems, or growth-operations ownership.