Sr. Manager Provider Operations

Experience at a health plan or in healthcare operations, with hands-on ownership of provider data, provider directory, credentialing, or network operations

Working knowledge of the regulatory environment governing provider directories — CMS Medicare Advantage directory and network adequacy requirements, and comfort reading and operationalizing regulatory guidance

Proficient in analyzing data sets to generate insights and turn those insights into action

Demonstrated success building repeatable operational processes with measurable quality outcomes, including QA frameworks and documented workflows

Experience managing or scaling offshore and/or vendor delivery teams

Experience applying AI and automation to reduce manual operational work

The Provider Operations team is responsible for delivering tight operations, meaningful data and analytics, user-friendly tools and content, and shared best practices across markets.

Foundational to this strategy is our ability to be an engine of accurate provider data, which is inherently complex, messy, and ever-changing.

Accurate and accessible provider data allows us to better serve our members and providers, reduces our administrative cost and burden, and keeps us compliant with a growing set of federal and state directory requirements.

This role owns provider data and directory accuracy end to end — from the validation and verification work that keeps our records current, to the compliance posture that makes our directory defensible in front of CMS, to the strategic question of how we turn the directory into a tool that actively navigates members to high quality, accessible care.

Manager will lead a hybrid onshore and offshore team and is expected to grow that team as we scale.

Own provider data accuracy end to end — validation, verification, exception handling, and remediation across roster intake, credentialing, and downstream publication to our member-facing directory