Who We Are at Sprout Therapy:
Sprout Therapy is a tech-forward provider of pediatric therapy across the United States. We believe that families, clinicians, and insurers all deserve a better healthcare experience, so we built one.
Backed by > $30mm from General Catalyst, Felicis Ventures, Founders Fund, & others. Our mission is to provide personalized, technology-empowered care for children with autism in the environment best suited to help them grow and thrive — the home. We’re looking to rapidly grow our team with values-driven, diverse, caring professionals to help us improve autism care.
As a Contract/Credentialing Manager, you will assist with leading and overseeing all Credentialing and PIM related deliverables. You will be responsible for ensuring timely processing of the initial files and re-credentialing files for owned and managed providers and ancillaries within compliance guidelines for multiple states. Also responsible for ensuring the accuracy of practitioner data in both internal databases and health plan directories, timely roster submissions and managing the submissions and term process.
What You’ll Do:
- Oversee, develop, and maintain systems, database programs, reports for credentialing and PIM
- Proactively invest in understanding the requirements of the departments and help develop and maintain key quality metrics
- Maintain all credential files, other relevant provider and ancillary focused information and maintain data integrity
- Help lead and coordinate key credentialing audits, develop responses for inquiries and ensure department compliance with all required audits and lead and corrections that are required within the committed timeline with the health plans
- Research and develop meaningful responses for regulatory bodies in response to their queries
- Work closely with Legal Counsel, Compliance Team, Senior Executives and the VP of Payor Relations on strategic decisions and directions
What You’ll Need:
- Bachelor's Degree
- Startup experience is a plus
- Ability to work to strict deadlines and targets
- 3-5 years' experience in similar field
- Strong organizational, project management and problem-solving skills with impeccable multi-tasking abilities
- Analytical responsibilities for credentialing information management and reporting is required
In addition to our clinicians and supporting departments, our company is built around four cross functional teams (spanning operations, product, marketing, business development, etc.):
- Demand - Deliver top notch products and services to our growing number of patients. You’ll work with families to understand pain points and optimize the patient journey from first contact to start of care to offboarding.
- Supply - Own and manage the relationship with our clinical practitioners. You are responsible for the growth of our clinician ecosystem by attracting, recruiting, and retaining high quality autism care providers.
- Platform - Build tools and provide services to optimize and improve the delivery of clinical care. You’ll help match the right provider with the right family, coordinate clinical care, and develop digital therapeutics products.
- Quality - Improve the quality of care delivered to our patients. You’ll ensure that we provide strong clinical outcomes, develop training platforms to level up our providers, and maintain compliance with a variety of payor and regulatory requirements.
At Sprout, everyone works remotely, but you don't feel remote. While we are a globally distributed team, many team members are located in the following cities: San Francisco, New York, Los Angeles, Toronto, Montreal, and Kyiv.
What We Believe:
- Patients first, everything else second: We put our patients first, always. No decision is made at Sprout without considering the value it would bring to our families.
- Think and act like an owner: We think of ourselves as not just employees but part owners. We understand that when Sprout thrives, we all thrive.
- Candor and respect: We can't achieve greatness without ever disagreeing. We need to have healthy debates to ensure that we're making the right decisions.
- Never settle for less: We don't settle for anything less than excellence. We're relentlessly committed to delivering the best care to our patients and always strive to do better by them.
The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required for the position.
Sprout Therapy is an equal opportunity employer that is committed to providing all employees with a work environment free of discrimination and harassment. We celebrate diversity and welcome applicants from every background and life experience.