SR. MANAGER, CREDENTIALING OPERATIONS
US Remote · Full-time
ABOUT FINNI HEALTH
Finni Health empowers autism care providers to start, run, and grow their own practices. We democratize autism care by providing access to our insurance network, purpose-built EHR software, HR solutions, and clinical support. We've experienced rapid growth and are backed by top-tier investors like General Catalyst and YCombinator. We seek smart, driven individuals eager to innovate in a dynamic, fast-paced environment.
WHAT YOU WILL BE DOING:
As Sr. Manager, Credentialing Operations, you will own the function that determines how fast a Finni practice can start seeing clients and getting paid. A provider who is not enrolled with a payer cannot be billed for, so credentialing sits in front of our revenue and in front of families waiting for care.
You will lead a team of twenty: four Credentialing Managers and sixteen coordinators and associates working offshore across time zones. Each manager owns one stage of the credentialing lifecycle. Onboarding & Submission runs from offer signed to first payer submission. Follow Up & Resolution runs from submitted to enrolled, and is not finished until proof of participation is attached. Provider Maintenance owns the provider record after enrollment, including licenses, expirations, re-attestation and roster accuracy. Enrollment Integrity owns accuracy across all three. Each stage carries its own measure.
This is a build job as much as a leadership job. Too much of how this function works today lives in a few people's heads, our reports do not always agree with each other, and the controls that should make it safe when someone is out are not all in place. You are here to run it and to make it durable.
- Team Leadership: Hire, develop and set the performance bar across managers and coordinators. Build the bench this function has not had.
- Completing the Reorganization: The function is moving from managers aligned to groups of practices to managers who each own one stage of the lifecycle. That transition is in flight and you will finish it. The hard part is not the org chart, it is keeping the state and payer knowledge that currently lives with a group-aligned manager while the work is re-cut around stages.
- Time to Enrolled: Own the number, meaning the days from a provider signing their offer to being enrolled with a given payer. Underneath it: blocked billing by cause, clean submission rate, aging and follow-up compliance. You own whether the number is right, not just whether the dashboard renders.
- Reporting We Can Trust: Reconcile the places our systems disagree about the state of an enrollment, and keep them reconciled.
- Controls and Coverage: Remove the single points of failure. The review queues, the payer configuration that governs who may bill, and the approvals that keep an unenrolled provider off a schedule should never depend on one person being at their desk. Build the cross-training, segregation of duties, and second set of eyes that make that true.
- Data-Handling and Payer Restrictions: A growing list of payers and state Medicaid programs prohibits offshore handling of protected health information. You will own the restricted-payer list, enforce it in how work is actually assigned rather than in policy alone, and tell us when the only answer is an onshore hire.
- Process and Documentation: Build the per-payer requirements library so a submission goes out as soon as that payer's minimum is met instead of waiting on the strictest payer on the list, plus written procedures by state and payer specific enough that a coordinator who has never worked a given state can submit there.
- Backlog Programs: Enrollment records without documented proof of network participation, enrollments still open on providers who have left, records with no approval date. Scope each one, run it to completion, and prevent it from recurring.
- Payer Relationships and Compliance: Provider-level revalidations, roster…