Operations Associate, Insurance & Clinical Operations
Core
Support clinical workflows and build the insurance/payer infrastructure for a direct-to-patient telehealth company specializing in obesity medicine.
Role type
Operations Associate (Clinical & Payer Operations)
Builds
Insurance program infrastructure, provider credentialing, billing operations, and clinical workflow optimization.
Domain
Healthcare / Telehealth / Insurance Operations
Required skills
Healthcare operations, revenue cycle management, payer contracting, provider credentialing, data analysis, compliance with CMS/state regulations, stakeholder management
Preferred skills
Health-tech or telehealth exposure, E&M or telehealth billing experience, familiarity with credentialing and revenue cycle concepts
Technologies
AI tools, EMR systems, data analytics platforms
Responsibilities
Optimize clinical workflows and care coordination; analyze performance data to track provider KPIs; manage provider credentialing and enrollment for insurance panels; support payer contracting and rate discussions; monitor claims and vendor performance; assist agents in reviewing billing and coding for compliance; maintain SOPs for billing rules and telehealth parity requirements; partner with Engineering to translate insurance needs into EMR requirements.
Seniority
Junior to Mid-level, hands-on IC