Manager, Payer Enrollment

As Payer Enrollment Manager, you’ll be a key leader in our credentialing and compliance operations. You’ll oversee both delegated and non-delegated credentialing processes, manage payer enrollment workflows, and ensure we meet accreditation and contractual requirements. This role requires close collaboration with internal stakeholders and external payer partners to scale processes, maintain compliance, and drive operational efficiency.

What you’ll be doing:

• Oversee and audit the performance of Credentialing Verification Organizations (CVOs), ensuring alignment with Spring Health’s standards and payer requirements.
• Lead audits and ongoing monitoring for delegated contracts, including preparation, execution, and response to corrective action plans (CAPs) as needed.
• Lead and manage all payer credentialing and enrollment functions across delegated and non-delegated arrangements.
• Ensure compliance with NCQA, CMS, state, and commercial payer credentialing requirements.
• Develop and optimize workflows for application submission, recredentialing, and ongoing monitoring.
• Serve as the primary point of contact for payer credentialing escalations, audits, and operational issues.
• Collaborate with Compliance, Product, and Revenue Cycle Management teams to ensure data accuracy and streamline processes.
• Track and analyze performance metrics related to credentialing and enrollment, identifying trends and opportunities for improvement.
• Support the development and ongoing refinement of internal policies, procedures, and audit-readiness documentation.
• Maintain detailed records and audit trails to support both internal reporting and external compliance.

What success looks like in this role:

• Shortened payer application processing timelines and increased provider enrollment efficiency.
• High compliance rates with NCQA, CMS, and payer-specific credentialing requirements.
• Timely resolution of credentialing escalations and successful completion of payer audits.
• Strong collaboration with internal teams and external stakeholders to support provider go-lives and reimbursement readiness.
• Implementation of scalable, repeatable processes that support continued growth and evolving payer partnerships.

What we expect from you:

• 5+ years of experience in healthcare credentialing, payer enrollment, or provider network operations.
• Deep knowledge of NCQA standards, CAQH, Medicare/Medicaid enrollment, and delegated credentialing structures.
• Experience managing CVOs and auditing third-party credentialing processes.
• Proven ability to develop and optimize credentialing workflows and policies.
• Strong communication and stakeholder management skills, especially when working with payers, compliance teams, and leadership.
• Analytical mindset with experience in data tracking, reporting, and operational performance monitoring.
• Comfortable working in fast-paced environments and balancing multiple priorities.

Preferred Qualifications:

• NAMSS Certification (CPMSM or CPCS) preferred.
• Experience implementing credentialing technology and automation tools.
• Background in payer contract management and compliance audits.

The target base salary range for this position is $97,325 - $114,500, and is part of a competitive total rewards package including stock options and benefits. Individual pay may vary from the target range and is determined by a number of factors including experience, location, internal pay equity, and other relevant business considerations. We review all employee pay and compensation programs annually using Radford Global Compensation Database at minimum to ensure competitive and fair pay.

Benefits provided by Spring Health:

Note: We have even more benefits than listed here and below, your recruiter will provide more in-depth information as you continue in the interview process. Benefits are subject to individual plan requirements and eligibility criteria.

• 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.