Conduit Health

Project Manager

• Optimize Key Partnerships. Manage partnerships with payor and supplier partners to ensure all orders are filled quickly, and patients have a seamless experience.
• Manage Prior Authorization Processes: Ensure efficient authorization processes, especially through various portals that require manual submission and constant follow-up.
• Collaborate Across Teams: Partner with Clinical Operations, Support, Payor Development, and Product Teams to share insights, improve workflows, and address operational challenges effectively.
• Track & Report KPIs: Measure performance metrics (e.g., patient reach rate, turnaround time, error rates), prepare reports, and present insights to leadership.

Project Manager – Operations

Operations

• 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.

Operations Manager

Associate

• Own your queue: Respond to patient, caregiver, and provider inquiries across phone, SMS, email, and chat — managing your queue with accuracy and care.
• Help patients navigate the process: Explain order status, insurance requirements, documentation needs, and next steps in clear, simple terms.
• Resolve issues end-to-end: Take ownership of patient issues and follow through until resolution, coordinating across internal teams as needed.
• Handle inbound and outbound calls: Support patients and caregivers through stressful or time-sensitive situations with professionalism and compassion.
• Identify operational gaps: Flag recurring patient questions and workflow gaps to help the team improve processes over time.
• Keep documentation accurate: Maintain clear and organized documentation so information is easy to track and nothing falls through the cracks.
• Escalate thoughtfully: Recognize when issues need additional support and ensure handoffs are clear and seamless.
• Work within AI-powered tools: Use AI-assisted support workflows, smart response suggestions, and automation to move faster and more consistently - and flag feedback.
• Adapt as we scale: Learn new workflows, tools, and processes quickly as the business evolves.

Patient Experience Associate

• Own the Full Billing Lifecycle: Manage every stage from EDI payor enrollment and claim submission through remittance posting and patient collections.
• Drive Daily Cash Flow: Monitor A/R Aging, identify stalled claims, and proactively resolve payor edits, rejections, and denials before they age.
• Manage EDI Infrastructure: Ensure EDI trading partner agreements are executed and tested before go-live dates.
• Lead the Denial Management Program: Build and run a structured denial and appeals workflow with the help of RCM leadership.
• Serve as a Vendor Liaison: Act as the primary point of contact for outsourced billing vendors and billing software partners, holding them accountable for SLA’s, submission quotas or timelines, and KPI’s assigned by Leadership.

Revenue Cycle Operations Manager

Clinical Operations

• Own our clinical service operations end to end: clinician supply, capacity, scheduling, care delivery performance, and quality across all encounters.
• Build the recruiting, credentialing, and licensing engine, and scale our clinician workforce to meet aggressive growth targets across multiple states.
• Develop and oversee clinical quality, including clinical SOPs, documentation standards, supervision structures, and medical-necessity rigor, ensuring consistent, high-quality, and compliant audit-ready care delivery.
• Design, pilot, and scale our longitudinal care program, including eligibility, consent, matching, time-tracking, and billing.
• Build and lead key teams: clinical providers, care management, and clinical HR / credentialing.
• Own the clinical P&L, optimize our staffing models, and transition us from external reliance to a proprietary, high-quality, and cost-efficient operating model.
• Define and monitor the operational and clinical KPIs that drive quality, access, efficiency, and profitability, using data to continuously improve performance.
• Join the leadership team and partner across Fulfillment, Patient Experience, Revenue Cycle, Product, and Engineering.

Head of Clinical Operations

Artificial Intelligence

• End-to-end AI deployments — design, test, and roll out browser/phone agents and document extraction (OCR + agentic AI) that automate authorization, verification, and intake workflows
• Workflow-to-spec translation — turn complex payer and clinical workflows into clear technical specs the AI can execute
• Output quality — measure accuracy, find where deployments fail, and drive them toward reliability ruthlessly
• Playbooks — document prompt and deployment strategies so they're reproducible and scale across states and payers
• The AI roadmap — prioritized, defended, and executed with conviction
• Metrics — define what "working" means and prove it

Project Manager – Operations

Operations Manager

Patient Experience Associate

Revenue Cycle Operations Manager

Head of Clinical Operations

AI Deployment Manager