Director, Qualification Engagement

The posting, as Lantern wrote it

About Lantern

Lantern is the specialty care platform connecting people with the best care when they need it most. By curating a Network of Excellence comprised of the nation's top specialists for surgery, cancer care, infusions and more, Lantern delivers excellent care with significant cost savings to employers and their workforces. Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the entirety of their care journey, helping them get back to good health, back to their families and back to work. With convenient access to specialists nationwide, Lantern means quality care is within driving distance for most. Lantern is trusted by the nation's largest employers to deliver care to more than 6 million members across the country. Learn more about us at lanterncare.com.

Director, Qualification Engagement

Lantern is looking for a Director, Qualification Engagement to join our Clinical team as the external voice of specialist qualification. Lantern operates a specialty care network built on a simple promise to clients and members: every specialist in our Network of Excellence has been evaluated, by procedure, against evidence-based clinical standards. The Clinical team sets those standards, runs the Qualification Committee, and is investing in the tooling and process that make qualification faster and more consistent for practices.

As that investment matures, the part of the process that will always require a human is the conversation with practices: explaining what we evaluate and why before a group applies, delivering approvals and procedure-level decisions clearly and respectfully, and giving groups that receive an adverse finding a credible explanation and a fair path to respond.

In this role you will own how qualification is explained, how decisions are delivered, and how practices experience the process. You will also bring the Clinical perspective into provider conversations and select client meetings and collaborate with the Provider Network team to educate and set our partner practices up for success. This is a Director-level individual contributor role, accountable for the entire qualification engagement function, with the potential to lead qualification operations staff as the function scales. This role suits two kinds of candidate: a seasoned credentialing, medical staff, or provider network leader, or a physician or surgeon ready to move from direct patient care into a high-impact role shaping network quality. What the role requires is credibility with surgeons and the judgment to deliver difficult clinical decisions well.

Location : Remote

Responsibilities

Qualification decision communications

• Deliver every qualification, requalification, and standing-change decision to practices and specialists, including full approvals, procedure-level approvals, holds pending information, denials, and removals from the network.
• Translate Qualification Committee reasoning into clear, accura

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relevant experience, location, and qualifications.

About You

• You use LOGIC in your decision making and understand that progress is critical to making change. You focus on the execution of your content while balancing a fast-paced environment and you take the time to celebrate both the small & big wins.
• INCLUSION is a core tenant of your personal beliefs. A diverse and inclusive environment is incredibly important to you. You understand and desire to be a part of a diverse team with different experiences and perspectives & you cherish the differences in each individual that you interact with.
• You have the GRIT , drive and ambition to tackle big problems. Big problems require big ideas and a team that supports new ideas.
• You care deeply for your customers are driven to keep HUMANITY in all decisions. Your customers aren’t just the individuals using your product. They are the driving factor in your motivation to make a change.
• Integrity guides you in life. Focusing on the TRUTH vs. giving people the answers they want to hear.
• You thrive in a Team Environment. Collaboration is key in innovation and creating change.

These pillars of LIGHT are a reminder to our team that we are making a difference by providing guidance and support in navigating the often complex and confusing landscape of healthcare. We hope that through this LIGHT , individuals can find their way to the best care, resources, and support they need to get back to life.

If this sounds like you, we would love to connect to speak further about career opportunities at Lantern.

Please apply to our role & someone from our Talent Acquisition Team will reach out to help you navigate our interview process.

Lantern does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity or any other reason prohibited by law in provision of employment opportunities and benefits.