Sr. Manager, Credentialing Operations

The posting, as Finni Health wrote it

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,

[…]
lity and Agility: Comfortable thriving in a dynamic, fast-paced startup environment, embracing change, and navigating ambiguity with a proactive mindset.

WHAT SUCCESS LOOKS LIKE

• First 30 days: You know the payer landscape we operate in, you have met every manager and coordinator, and you can tell us where the days actually go between offer signed and enrolled.
• First 60 days: Time to Enrolled is reported weekly and we trust the number. Blocked billing is on a dashboard with a cause and an owner against every line. No step in the function depends on a single person being available, and you can show us the coverage plan.
• First 90 days: Blocked billing from enrollment is measurably down and the trend has turned. The per-payer requirement library covers our top payers by volume. A new coordinator can be trained from written material instead of by shadowing.
• First 6 months: The stage-based structure is fully in place and the state and payer expertise survived the move. The manager layer is stable and developing, and you are telling us what credentialing should look like two years out rather than reacting to what it looks like today.

WHAT THIS ROLE IS NOT

You do not own payer contracting or payer sales. Negotiating and signing payer agreements is a separate function with its own leader, and you own getting providers enrolled under the agreements we have. Group and facility-level enrollment, organization revalidations and single case agreements sit with that same function, so your scope is the provider rather than the organization. You do not own claims or collections either. Revenue cycle owns a claim once it is clean, and you own whether the provider was enrolled so the claim could go out at all.

BENEFITS

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

Ready to make a significant impact at a rapidly growing healthcare startup? We'd love to hear from you!