Director, Qualification Engagement

Lantern•Dallas, NY

11d•Hybrid

About The Position

Lantern is seeking a Director, Qualification Engagement to own how specialist qualification is explained, decisions are delivered, and practices experience the qualification process. Lantern’s Clinical team evaluates specialists in its Network of Excellence by procedure against evidence-based clinical standards. This role makes that process clear, consistent, respectful, and efficient for practices and specialists, while bringing clinical perspective to provider conversations and select client meetings. This is a Director-level individual contributor role accountable for the qualification engagement function, with potential to lead qualification operations staff as the function scales. The role is suited to an experienced credentialing, medical staff, or provider network leader, or a physician, surgeon, or other licensed clinician moving beyond direct patient care. The expected mix after ramp-up is approximately 70–80% qualification and practice-facing work and 20–30% provider and client representation. Commercial representation begins after the first 90 days. The position is based in Dallas, TX or New York, NY, with a hybrid schedule requiring three days in the office per week. The base salary range is $160,000–$180,000, with bonus potential depending on relevant experience, location, and qualifications.

Requirements

Bachelor’s degree or equivalent professional experience.
Credibility with surgeons and practice leaders, with the ability to deliver difficult, clinically grounded decisions while preserving relationships.
Either a clinical background as a physician or surgeon (MD or DO), or another licensed clinician seeking to apply clinical judgment beyond direct patient care; or at least 10 years of experience in medical staff services or credentialing leadership, payer provider network or provider relations management, or surgical practice or ASC administration, including clinical operations in orthopedics, spine, bariatrics, or multi-specialty surgery.
Exceptional written and verbal communication, including the ability to explain complex criteria without jargon or condescension and conduct difficult conversations with surgeons or practice executives.
High emotional intelligence and judgment, including the ability to balance empathy and firmness and know when to listen, explain, or escalate.
Working knowledge of surgical specialties and procedures, surgical practice operations, surgeon training and credentialing, and how practice administrators, schedulers, and billing teams interact with payers and networks.
Independent problem-solving and project-management skills, including the ability to run multi-step processes, track details, and improve processes.
Comfort with data and tools, including interpreting data-driven profiles, volume thresholds, and outcome metrics; spotting errors; and working fluently in Microsoft 365 and modern software tools, including AI-assisted drafting with appropriate review.
Integrity under pressure and willingness to uphold standards and route requests for exceptions through the proper review process.
Experience setting strategy for a function or program, influencing senior leaders and physicians without formal authority, and readiness to build and lead a team or grow into that responsibility as the function scales.

Nice To Haves

Credentialing or medical staff certification, such as CPCS or CPMSM through NAMSS.
Direct experience communicating adverse credentialing or peer review determinations to physicians.
Experience building enablement or training materials for field or account teams.
For candidates with a clinical background: experience beyond direct patient care, such as medical directorship, utilization or peer review, committee or quality work, or clinical research.
Experience presenting to employer benefits leaders, consultants, or health plan audiences.
Enthusiasm for building a function from the ground up with new tooling, and urgency and precision when a practice or member is waiting for an answer.

Responsibilities

Deliver qualification, requalification, and standing-change decisions to practices and specialists, including approvals, procedure-level approvals, holds pending information, denials, and removals from the network.
Translate Qualification Committee reasoning into clear, accurate, clinically literate written and verbal communications that practices and specialists can act on.
Own adverse-finding workflows by requesting documentation or clarification, tracking responses, returning complete information to the Committee, and closing the loop within defined service levels.
Respond to pushback consistently and calmly, explain the rationale and published guideline review process, and escalate cases to the Associate CMO when they require clinical judgment beyond the guidelines.
Maintain correspondence records so decisions and their communication histories can be reconstructed and audited.
Build and maintain practice-facing explanations of qualification, including the seven quality domains, data sources, thresholds, and process stages.
Lead qualification overview conversations with prospective and newly contracted practices so they understand requirements before investing effort and unqualified candidates can be identified before contracting.
Set qualification guidance for Provider Success Managers so they can answer routine questions accurately and manage practice relationships without unnecessary Clinical escalation.
Communicate guideline changes to affected practices and specialists, including re-evaluation pathways when standards evolve.
Own the workflow from Committee decision to delivered communication, including letter generation from Prism, tracking, and turnaround reporting against the five-business-day target from submission to decision.
Coordinate the Qualification Committee agenda and decision record with the Clinical Quality Manager, and ensure a clean, timely handoff to Network for placeability.
Capture and triage practice feedback, and define and report metrics that show whether the qualification process is working.
Represent Clinical on provider calls requiring clinical context, including qualification questions, clinical escalation feedback, and specialist-facing quality discussions; apply defined criteria for when a physician leader should join.
Represent the Clinical team in select commercial pitches and client conversations.
Set the strategy, operating model, and service levels for qualification engagement; build the staffing case as volume grows; and represent the function in leadership forums alongside the Clinical team.