About The Role
The role owns the administrative backbone of healthcare operations: provider credentialing, HIPAA compliance oversight, payer relations, and day-to-day management of clinical and non-clinical staff across a multi-site care network.
This is a critical function in a healthcare technology organization serving US payers and providers — the role ensures regulatory compliance (HIPAA, CMS, state licensure), keeps operational budgets on track, and directly impacts patient access, billing accuracy, and care-quality metrics.
Key Responsibilities
- Oversee daily administrative operations across departments, including scheduling, staffing, budgeting, and vendor management
- Ensure organizational compliance with HIPAA, CMS regulations, Joint Commission standards, and state licensure requirements; own audit preparation and remediation
- Manage provider credentialing and payer enrollment cycles, tracking renewals and re-credentialing timelines in credentialing systems (e.g., CredentialStream or equivalent)
- Analyze operational and financial KPIs — patient throughput, claim denial rates, staffing utilization — and report findings to leadership monthly
- Partner with clinical leadership to design and implement workflow improvements in the EHR and practice management systems (Epic, Cerner, or similar)
- Develop and administer departmental budgets, negotiating vendor contracts and managing expense variance
- Recruit, train, and evaluate non-clinical support staff; build succession and coverage plans for key administrative functions
What We Are Looking For
- 3-6 years of healthcare administration experience in a provider, payer, or healthcare technology setting
- Bachelor's degree in Healthcare Administration, Business, Public Health, or related field; MHA or MBA preferred
- Working knowledge of HIPAA, CMS compliance frameworks, revenue cycle management, and payer contracting
- Hands-on experience with EHR and practice management platforms (Epic, Cerner, Athenahealth, or similar)
- Strong analytical skills; proficient with Excel, BI dashboards, and operational reporting
- Demonstrated success managing cross-functional teams and driving process improvements with measurable outcomes
- Bonus: FACHE or FACMPE certification; experience with telehealth operations or value-based care programs; familiarity with CMS quality reporting programs (MIPS, HEDIS)