Director of Credentialing Operations
Our purpose
SonderMind is a VC-backed digital health company redesigning behavioral health through covered and timely access, increased utilization, and data-validated quality outcomes. We are a team of Explorers, Builders, and Change Makers democratizing the complicated world of behavioral healthcare for therapists and clients alike.
How you’ll make an impact
The Director of Credentialing Operations will be responsible for overseeing SonderMind’s credentialing program to assure compliance with payor’s credentialing requirements, delegated agreements and NCQA requirements. In this role, you will build a credentialing program that exceeds quality and compliance standards, and provides a best-in-class experience for our providers. You will also be responsible for designing and implementing processes and procedures that continue to move our business forward.
Success looks like
- Learn our current credentialing processes, understand areas of strengths and weaknesses. Develop a plan to improve upon our current process.
- You are seen as the Subject Matter Expert with all things credentialing across the company
- Work cross-functionally with company leaders to improve upon process flow to maintain best-in-class operations and quality for our providers
- Mentor and coach team in a remote and hybrid environment
What you’ll do
- Maintain an NCQA compliant program at all times
- Ensure sure all Medicare entity and provider assignment applications are filed with Medicare in a timely manner to support SonderMind’s expansion
- Manage all Credentialing Committee operations under partnership with our Chief Medical Officer
- Vendor management with our credentialing verification organization (CVO)
- Partnering closely with payor operations on all activities including: managing new payor setups, supporting delegated credentialing contracting processes and solving credentialing and rostering issues as they arise
- Own the Serious Incident Report (SIR) process for clients and providers (in partnership with Clinical Quality Director)
- Owning the credentialing, network monitoring, and re-credentialing processes (in partnership with Clinical Quality Director)
- Ensure providers are abiding by SonderMind’s network policies (in partnership with Clinical Quality Director)
- Own the process development and staffing to support manual submission of provider credentialing applications to a rapidly expanding portfolio of payors across new markets
What you'll bring with you
Critical Competencies
Customer Focused: ability to put yourself in our provider’s shoes, focused on the needs, wants, and expectations of our providers.
Drive for Results: bias for action, high intrinsic motivation, thrives under pressure, maximizes opportunities, and makes bold decisions at the right times
People Management: exhibiting the courage and skills to effectively and thoughtfully lead, motivate, and inspire others
Professional Competency: Deep knowledge of credentialing processes and operations. Knowledge of industry/trends. Always learning and improving
Quality of Work: freedom from errors and mistakes and the ability to consistently meet objectives; high attention to detail.
Strategic Perspective: understands the position of the organization with a global context. Able to anticipate future trends, consequences, and opportunity-costs, and to map a clear path of acceleration toward strategic opportunities.
Experience
- Trained/certified in NCQA
- 7 +years of direct credentialing experience with a minimum of 2 years of leadership experience
- Ability to manage a remote team/hybrid team
- Outstanding attention to detail
- Ability to build and implement process flows as well as manage process flow metrics
- Experience adapting day-to-day process flows depending on unanticipated variables that the business might encounter
- Proven experience in iterating through small, manual pilots and building scaled operations in areas where it makes sense
- Demonstrated experience in building structure where it previously did not exist. Can be a steady, mature pilot of the proverbial plane that is being built while in the air
- Ability to work cross-functionally
- Bachelor’s degree required
- Master’s degree preferred
- Behavioral health experience preferred
Other Details
- This role can sit in the following cities: Denver, CO, Austin, TX, Seattle, WA, Boston, MA, Madison, WI, Pittsburgh, PA, Raleigh, NC, Chicago, IL
- Compensation range for this position is $110,000-$125,000. Actual title and compensation is commensurate with experience and skills.
What we value
- Transparency: We say what we mean and mean what we say
- Bucketworthiness: We can be relied upon to not let our bucket leak
- Ownership: We take initiative to act before being asked
- Courage: We move fast, take calculated risks and (sometimes) fail
- Empathy: We treat others with respect and assume their best intentions
- Passion: We loosely hold strong opinions, debate and then commit forcefully
Commitment to an Inclusive Workplace
Mental wellness impacts people of every community. At SonderMind, building and supporting a diverse workforce is foundational to our goal to redesign behavioral healthcare to be more approachable and accessible. SonderMind is a committed equal opportunity employer and provides a workplace that will not tolerate discrimination or harassment.
Our employees may be exposed to sensitive personal information throughout their regular duties. For this reason, we maintain exceptionally high expectations of ethical conduct and require all incoming employees to pass a background check.
Our Employee Benefits Philosophy
As a leader in redesigning behavioral health we are walking the walk with our employee benefits package. We focus on meeting SonderMinders wherever they are and supporting them in all facets of their life with both mental and physical aspects in mind. Where most companies say "good enough" we ask ourselves "how can we do better." That includes:
- Therapy coverage benefits to enable our employees to get the care they need
- Employer-paid disability & AD&D to cover life's unexpected - not only that, we cover the difference in salary for up to Eight weeks of short-term disability leave
- Eight weeks of paid parental leave (if the parent also qualifies for STD, this benefit is in addition)
- A generous PTO policy and a company mandate of at MINIMUM three-weeks of PTO a year; flexible work-from-home policy
- A commitment to reward our team members for the long-term success and growth of SonderMind with stock option grants and bonus potential
- Competitive market salary, up-to 4% salary company match on 401K, professional development and advancement opportunities as we rapidly scale, and so much more.