Sr. Manager, Credentialing Operations

Finni Health•,

11d•$115,000 - $140,000•Remote

About The Position

Finni Health is seeking a Sr. Manager, Credentialing Operations to lead and build the function responsible for enrolling providers with payers so Finni practices can begin seeing clients and billing for care. The role leads a team of 20, including four Credentialing Managers and 16 offshore coordinators and associates across time zones. Managers own separate stages of the credentialing lifecycle: onboarding and submission, follow-up and resolution, provider maintenance, and enrollment integrity. The role combines operational leadership with process development. The Sr. Manager will complete the transition from practice-aligned management to lifecycle-stage ownership while retaining payer and state expertise. They will own and validate time-to-enrollment reporting, reconcile enrollment data across systems, reduce billing blocks, build controls and coverage, and ensure payer and state restrictions on handling protected health information are reflected in work assignment. They will develop payer-specific requirements and procedures, lead backlog cleanup programs, oversee provider-level revalidations and roster accuracy, and partner with Product during an enrollment-systems migration. The Sr. Manager works closely with Practice Success, revenue cycle, payer contracting, HR, and compliance. The position does not own payer contracting or sales, group or facility-level enrollment, organization revalidations, single case agreements, claims, or collections. It owns provider enrollment under existing agreements and adapts to evolving responsibilities as Finni Health grows and regulations change.

Requirements

At least 5 years of experience in provider credentialing or payer enrollment across multiple states and commercial payers and Medicaid or Medicaid managed care; Medicaid experience is required.
Hands-on experience with CAQH, NPPES, PECOS, state Medicaid portals, and commercial payer portals, including personally submitting applications and understanding where they stall.
At least 2 years of experience managing and developing a team; experience leading leads or managers is preferred within the role description.
Experience changing a team's structure and maintaining knowledge and performance through the transition.
Demonstrated ability to identify operational inefficiencies and build and implement solutions, including usable SOPs, designed workflows, and SLAs enforced with a team.
Strong ability to analyze operational data, identify trends and root causes, define metrics, investigate anomalous results, and implement data-driven solutions.
Knowledge of credentialing as a control function, including delegated credentialing, NCQA standards, payer audits, and data-handling restrictions; sound compliance judgment.
Experience leading or working closely with offshore teams and an informed perspective on what is effective.
Excellent written and verbal communication and ability to collaborate across internal teams and with external stakeholders, including payers.
Proficiency with Google Suite, Slack, and credentialing platforms such as Verifiable, Medallion, Modio, Symplr, or CAQH ProView.
Passion for Finni Health's mission to democratize autism care and empower providers to run strong, compliant practices.
Ability to thrive in a dynamic, fast-paced startup, embrace change, and navigate ambiguity proactively.

Nice To Haves

Experience writing requirements for a product or engineering team.
Experience leading managers or team leads, rather than only individual contributors.

Responsibilities

Hire, develop, and set performance expectations for credentialing managers, coordinators, and associates.
Complete the transition from practice-aligned management to stage-based ownership of the credentialing lifecycle while preserving state and payer knowledge.
Own time-to-enrollment, including the accuracy of the metric and monitoring blocked billing by cause, clean submission rate, aging, and follow-up compliance.
Reconcile enrollment status across systems and maintain reliable, consistent reporting.
Build cross-training, segregation of duties, backup coverage, and review controls to eliminate single points of failure.
Maintain the restricted-payer list and ensure payer and state Medicaid restrictions on offshore handling of protected health information are enforced in work assignments; identify when onshore hiring is necessary.
Build a per-payer requirements library and written state- and payer-specific procedures that enable timely submissions and coordinator training.
Scope and complete backlog programs involving missing proof of network participation, enrollments for departed providers, and missing approval dates, and prevent recurrence.
Manage provider-level revalidations, roster management, directory accuracy, and demographic updates; assess risks and make recommendations on options such as provisional credentialing.
Represent credentialing in Product by translating operational needs into engineering requirements and verifying that solutions work; support the enrollment-systems migration.
Collaborate with Practice Success, revenue cycle, payer contracting, HR, compliance, payers, and other stakeholders.
Take on evolving responsibilities as Finni Health grows and the regulatory landscape changes.