Operations Manager

Conduit Health•New York, NY

22d•$70,000 - $120,000•Hybrid

About The Position

Conduit Health is transforming one of the hardest, most outdated corners of post-acute care - getting essential medical equipment and supplies into patients' homes. We're the first vertically integrated, AI-powered platform to unite ordering, telehealth, prescriptions, insurance, and fulfillment into one seamless experience. In seconds, case managers and providers can say "yes" to patients who would otherwise wait weeks - while we handle every step behind the scenes. We're looking for an Operations Manager to investigate, troubleshoot, and resolve the eligibility, benefits, prior authorization, and coverage nuances across patients and health plans. This is detective work: when an order stalls, you trace it back to root cause - a coverage lapse, the wrong plan on file, an MCO carve-out, an entity or NPI mismatch, a documentation gap - and you fix it so it doesn't recur. You'll report to the Head of Operations and work closely with our RCM, fulfillment, and product teams to keep orders clean, moving, and compliant while we scale across states. This role offers a unique opportunity to shape insurance operations in a high-growth startup environment, working hands-on with industry leaders and driving impact across our patient population.

Requirements

3+ years in DME or healthcare insurance operations, eligibility/benefits verification, prior authorization, RCM, or medical billing.
Strong working knowledge of Medicaid, Medicare, and commercial payer rules; DMEPOS experience a strong plus.
Hands-on experience with eligibility and clearinghouse tools (e.g., Availity, eMedNY, payer portals) and EMR or order-ordering platforms.
An investigative mindset - you enjoy untangling messy, ambiguous problems and getting to the bottom of them.
Experience building SOPs and improving processes in a regulated environment.
Stellar communication and collaboration skills.

Responsibilities

Investigate coverage and eligibility: Verify insurance, discover unknown or secondary coverage from patient demographics, and resolve mismatches between eligibility results and order routing.
Do the detective work: When an order is stuck, trace it to root cause - lapsed coverage, wrong plan, MCO carve-out, entity/NPI mismatch, documentation gaps - and drive it to resolution.
Own prior authorization: Submit, track, and follow up on prior auths and appeals; keep turnaround tight.
Work denials and rejections: Resolve them, identify the patterns behind them, and close the gaps that cause them.
Research payers: Maintain working knowledge of plan structures, coverage policies, and fee schedules across our active and expansion states.
Build the systems: Develop and maintain SOPs; turn recurring investigations into repeatable, ideally automated, workflows.
Track & report KPIs: Measure eligibility hit rate, auth turnaround, denial rate, and clean-order rate; prepare reports and surface insights to leadership.