Senior Director, RCM & Credentialing
Spring Health
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $187,400 - $243,700 per year
Job Level
Senior
Tech Stack
GoSpring
About the role
- Develop and evolve a comprehensive RCM and payer operations strategy aligned with Spring Health’s enterprise and D2C business goals
- Collaborate with executive leadership to identify opportunities for margin expansion, DSO reduction, and operational scale
- Shape the long-term roadmap for system modernization, tooling upgrades, and automation efforts
- Foster a high-accountability, high-support culture with clear expectations, growth paths, and leadership development
- Lead the end-to-end revenue cycle, including eligibility, charge capture, coding, submission, collections, and appeals
- Drive clean claims rates, reduce denials, improve reimbursement timelines, and optimize AR performance
- Partner with Finance on forecasting, revenue recognition, and payment modeling (commercial and D2C)
- Manage payer escalations and work to improve contract adherence and payer performance
- Oversee provider credentialing and enrollment to ensure timely onboarding and plan participation
- Manage NCQA compliance, CVO partnership, delegated credentialing protocols, and payer-specific workflows
- Partner with Product and Engineering to design scalable internal tools, automations, and workflows
- Evaluate and implement technology to increase efficiency and reduce error rates
- Lead data hygiene and visibility efforts to ensure clean provider data and actionable performance insights
- Serve as a primary point of contact for payers, managing escalations and driving operational alignment
- Collaborate with Payer Relations and Legal to support contracting, credentialing delegation, and regulatory compliance
- Partner with Clinical Ops, Finance, Sales, and Go-To-Market to ensure operational readiness for new partnerships and launches
Requirements
- 10+ years in healthcare operations with deep experience in RCM, claims, and credentialing
- Proven experience leading large-scale, multi-layered teams (50+ FTEs)
- Strong understanding of payer lifecycle, EDI flows, denial management, and reimbursement strategy
- Experience in health tech, MSO, or D2C models with exposure to hybrid revenue streams
- Cross-functional leadership experience, especially with Product and Engineering
- Skilled in platform transitions, automation design, and reporting architecture
- Metrics-driven mindset with the ability to define, monitor, and act on performance data
- Familiarity with delegated credentialing, payer compliance, and NCQA audits
- Passion for mental health access and mission-driven care.
Benefits
- Health, Dental, Vision benefits start on your first day at Spring. You and your dependents also receive access to One Medical accounts HSA and FSA plans are also available, with Spring contributing up to $1K for HSAs, depending on your plan type.
- Employer sponsored 401(k) match of up to 2% for retirement planning
- A yearly allotment of no cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents.
- We offer competitive paid time off policies including vacation, sick leave and company holidays.
- At 6 months tenure with Spring, we offer parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents.
- Access to Noom, a weight management program—based in psychology, that’s tailored to your unique needs and goals.
- Access to fertility care support through Carrot, in addition to $4,000 reimbursement for related fertility expenses.
- Access to Wellhub, which connects employees to the best options for fitness, mindfulness, nutrition, and sleep in one subscription
- Access to BrightHorizons, which provides sponsored child care, back-up care, and elder care
- Up to $1,000 Professional Development Reimbursement a year.
- $200 per year donation matching to support your favorite causes.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
revenue cycle managementclaims managementcredentialingdenial managementreimbursement strategyautomation designreporting architecturepayer complianceNCQA compliancedata hygiene
Soft skills
cross-functional leadershipteam leadershipcollaborationoperational alignmenthigh-accountability culturegrowth paths developmentcommunicationproblem-solvingmetrics-driven mindsetpassion for mental health access