Credentialing Manager

Finni Health; Northern (KY); Hybrid; USD 80,000 - 110,000; Full time

Job summary

Finni Health is seeking a Credentialing Manager to optimize revenue cycle operations and scale the payer network. You will guide enrollment submissions and oversee an offshore team, ensuring efficient processes and regulatory compliance across CMS, NCQA, and internal standards.

You must have Medicaid experience and 5+ years in credentialing or related roles, with strong analytical, collaboration, and communication skills.

Qualifications

• 5+ years of credentialing or related roles in healthcare tech or early-stage startups.
• Medicaid experience is required.
• Strong understanding of payer credentialing prerequisites and blockers.
• Demonstrated ability to manage enrollment submissions and payer relationships.

Responsibilities

• Payer Network Management: scale insurance contracts and unblock applications with payers; onboard and maintain relationships.
• Offshore Team Management: oversee enrollment submission team; ensure productivity and accurate updates in credentialing platform.
• Customer Triage: address payer enrollment questions for providers and staff.
• Compliance and Quality Assurance: ensure adherence to CMS, NCQA, and internal policies; maintain compliance across RCM functions.
• Operational Efficiency and Project Management: lead workflow improvements to maximize reimbursement and reduce denials; manage projects.
• Cross-Functional Collaboration: partner with product, provider success, compliance, HR, and finance to align RCM with business goals.
• Adaptability & evolving responsibilities as Finni Health grows.

Skills

RCM expertise

Cross-functional collaboration

Analytical problem-solving

Communication

Organizational skills

Adaptability

Tools

Google Suite

Slack

CRM software

EHR/RCM tools

Job description

About Finni Health

Finni Health empowers autism care providers to start, run, and grow their own practices. We democratize autism care by providing access to our insurance network, purpose-built EHR software, HR solutions, and clinical support. We've experienced rapid growth and are backed by top-tier investors like General Catalyst and YCombinator. We seek smart, driven individuals eager to innovate in a dynamic, fast-paced environment.

What You Will Be Doing:

As a Credentialing Manager (Individual Contributor), you will play a critical role in optimizing our revenue cycle operations. Your primary responsibilities will include:

• Payer Network Management: Drive efforts to scale Finni's network of insurance contracts and unblock stalled applications with payers, ensuring efficient onboarding and ongoing relationship management.

• Offshore Team Management: Oversee enrollment submission team to ensure productivity expectations are met, active payer follow-up is timely, consistent, accurate, and recorded in the credentialing platform.

• Customer Triage: Triage questions around payer enrollment updates, status, and general questions for providers and their respective support staff

• Compliance and Quality Assurance: Ensure strict adherence to payer regulations, industry standards (e.g., CMS billing, NCQA Guidelines, Delegated Credentialing), and internal policies, maintaining high service and compliance standards across all RCM functions.

• Operational Efficiency and Project Management: Lead workflow optimization initiatives within RCM, manage specific projects, and drive continuous process improvements to maximize reimbursement and minimize denials.

• Cross-Functional Collaboration: Collaborate extensively with product, provider success, compliance, HR, finance, and other teams to align RCM efforts with overall business objectives and drive strategic goals.

• Additional Responsibilities: Adapt and take on evolving responsibilities and projects as Finni Health grows and the RCM landscape changes.

About You:

You are a proactive and collaborative individual contributor with a strong background in revenue cycle management, driven by a commitment to operational excellence and financial performance.

• Experience: 5+ years of relevant experience in credentialing or related roles, preferably in an early-stage startup, behavioral or mental health, or healthcare tech. Strong understanding of the payer credentialing processes, including core credentialing prerequisites, credentialing blockers and solutions to remediate, roster management, and demographic updates. Medicaid experience is required.

• Collaborative & Independent Contribution: Proven ability to work effectively within a team environment, contributing to collective success, and independently driving credentialing initiatives.

• RCM Expertise: Deep understanding of the full revenue cycle, including billing, claims processing, collections, accounts receivable management, payer contracting, and compliance (e.g., CMS billing).

• Analytical & Problem-Solving: Strong ability to analyze complex RCM data, identify trends, root causes of issues, and implement effective, data-driven solutions to optimize financial performance.

• Process Optimization: Demonstrated expertise in identifying inefficiencies and driving process improvements for RCM efficiency and effectiveness.

• Communication & Collaboration: Excellent written and verbal communication skills, with proven ability to effectively collaborate with internal teams and external stakeholders (payers, vendors, providers).

• Organizational & Time Management: Exceptional organizational and time management skills, with the ability to manage multiple priorities and projects in a fast-paced environment.

• Tech Proficiency: Proficient in Google Suite, Slack, CRM/support software, and EHR/RCM management tools. Experience with various EMR/EHR work queue management within RCM is a plus.

• Mission Alignment: Passion for Finni’s mission to democratize autism care and empower providers through robust RCM.

• Adaptability & Agility: Comfortable thriving in a dynamic, fast-paced startup environment, embracing change, and navigating ambiguity with a proactive mindset.

Ready to make a significant impact at a rapidly growing healthcare startup? We'd love to hear from you!