Operations

• Maintenance and advancement of the clinician network (physicians, genetic counselors, and registered nurses) to serve Everly’s present and future needs.
• Recruitment efforts including identifying candidates, reviews CVs, and interviewing physicians, registered nurse (RN), genetic counselor, and other clinicians.
• Identify appropriate avenues for recruitment (e.g., job boards, internal postings, referrals, etc.).
• Create and maintain policies and procedures related to the recruitment and onboarding processes to ensure consistent quality in the recruitment, interview, and onboarding of network providers.
• Facilitate credentialing, licensing, and training clinicians on the Everly platform, including management of Credentialing Verification Organization (CVO) vendor relationship to ensure that credentialing files are completed timely and accurately. Ensure candidates are approved by PWNHealth’s credentialing committee prior to extending any offer letters to ensure that all providers meet PWNHealth standards.
• Onboarding and training to ensure a seamless process for the onboarding of newly contracted providers and maintain provider satisfaction. Ensures that provider network is compliant with all applicable training requirements.
• Ensure the Network Management team collaborates with clinical, product, and project management teams to develop comprehensive physician and nurse trainings.
• Work in conjunction with the broader team to ensure programs are prepared for a successful launch, including clinician staffing, platform setup, and monitoring tools.
• Respond to clinician escalations and assists with any provider-related inquiries as needed/required.
• Prepare strategic licensure plans and works in conjunction with the Network Management team to identify candidates for additional licensure.
• Work with the team to provide guidance as needed/required and act as a liaison between the providers and respective boards (eg- medical boards, nursing boards, etc.).
• Prepare financial analyses to identify areas for licensing expansion to support and anticipate future business needs.
• Processes clinician monthly billing and invoicing any other vendor payments.
• Responsible for all communications to the physician and nurse network, including clinical protocol updates, issue resolution, licensure reminders, and other areas, as needed.
• Ensure our telehealth practice has the appropriate policies and procedures in place for proper functioning and governance, as well as supporting monitoring and QA.
• Collaborate with the legal team to ensure compliance with processes, such as contracting guidance, video/phone regulations, and contractor regulations.
• Maintain all network records, including employee files and relevant documents to ensure they are up-to-date. Provides documents as needed/requested to any network provider (e.g., employment verification).
• Maintain familiarity and working knowledge of the payor space and complexity involved in contracting and credentialing with payers (e.g., Government, Commercial, & Private payers) & collaborates with Payor Operations to execute payor contracts.
• Collaborate cross-functionally to monitor patient experience and follow-up efforts including but not limited to NPS survey, provider feedback, patient testimonials.
• Serve as a key resource for network and telehealth related inquiries across the organization.
• Facilitate quality assurance of the provider network.
• Develop and works to create efficiencies for new and existing processes and procedures.
• Develop departmental processes and procedures on all current workflows and works to create efficiencies.

Telehealth Network and Operations Manager

Technical Operations Analyst

Operations Manager

Manager, Patient Access – Reimbursement Operations

Director, Sales Operations

Deputy Director, Operations