Senior Manager, Credentialing Operations

Finni Health (YC W23)

. Lead the credentialing operations function that determines how quickly Finni practices can begin seeing clients and getting paid .

Posted 11/6/2026full-timeRemote • United StatesSenior💰 $115,000 - $140,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates extensive experience in provider credentialing and payer enrollment, with a strong focus on operational efficiency, team leadership, and compliance with Medicaid and commercial payer requirements. Proficient in managing cross-functional teams and adapting to evolving regulatory landscapes.

Highest-signal resume keywords

Provider CredentialingPayer EnrollmentTeam ManagementOperational Data AnalysisMedicaid Experience

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Credentialing OperationsProcess ImprovementData-Driven SolutionsApplication SubmissionEnrollment Delay ResolutionDelegated CredentialingNCQA StandardsPayer AuditsRisk EvaluationBacklog Management

Soft Skills

Excellent Communication SkillsTeam DevelopmentAdaptabilityCollaboration

Tools & Technologies

Google SuiteSlackCAQHNPPESPECOSMedicaid PortalsCommercial Payer PortalsVerifiableMedallionSymplr

Industry Keywords

Multi-State ExperienceMedicaid Managed CareCredentialing LifecycleOperational NeedsData-Handling Restrictions

About the role

Key responsibilities & impact

Lead the credentialing operations function that determines how quickly Finni practices can begin seeing clients and getting paid
Lead a team of four Credentialing Managers and sixteen coordinators and associates working across time zones
Hire, develop and set performance standards across managers and coordinators
Complete the transition from practice-group-aligned managers to stage-based credentialing lifecycle ownership
Own Time to Enrolled, blocked billing by cause, clean submission rate, and aging and follow-up compliance
Reconcile conflicting enrollment status data across systems and maintain trusted reporting
Build controls, cross-training, segregation of duties and coverage plans to remove single points of failure
Own restricted-payer lists and enforce data-handling restrictions for payers and state Medicaid programs
Build per-payer requirements libraries and state- and payer-specific written procedures
Scope and complete backlog programs involving missing participation proof, departed providers and missing approval dates
Manage provider-level revalidations, roster management, directory accuracy and demographic updates
Evaluate risks and make recommendations regarding options such as provisional credentialing
Represent credentialing in Product, translate operational needs into engineering requirements, and verify delivered solutions
Collaborate with Practice Success, revenue cycle, payer contracting, HR and compliance
Adapt to evolving responsibilities as Finni Health grows and regulations change

Requirements

What you’ll need

5+ years in provider credentialing or payer enrollment
Multi-state experience across commercial payers and Medicaid or Medicaid managed care
Medicaid experience required
Hands-on experience with CAQH, NPPES, PECOS, state Medicaid portals and commercial payer portals
Experience submitting applications directly and resolving enrollment delays
2+ years managing and developing a team
Experience restructuring a team and changing how work is divided
Demonstrated expertise identifying inefficiencies and building process improvements
Strong ability to work with operational data, identify trends and root causes, and implement data-driven solutions
Familiarity with delegated credentialing, NCQA standards, payer audits and data-handling restrictions
Experience leading or working closely with offshore teams
Excellent written and verbal communication skills
Proficiency in Google Suite, Slack, and credentialing platforms such as Verifiable, Medallion, Modio, Symplr or CAQH ProView
Experience writing requirements for a product or engineering team is a plus
Passion for Finni's mission to democratize autism care
Comfortable working in a dynamic, fast-paced startup environment and navigating ambiguity

Benefits

Comp & perks

401(k)
Health insurance
Dental insurance
Vision insurance
Flexible schedule
Paid time off
Paid Holidays