Credentialing/Payor Enrollment Specialist

Why We're Here

At Brave Health, we are driven by a deep commitment to transform lives by expanding access to compassionate, high-quality mental health care. By harnessing the power of technology, we break down barriers and bring mental health treatment directly to those who need it most-wherever they are. As a community health-centered organization, we are dedicated to ensuring that no one is left behind.

Nearly 1 in 4 people in the U.S. receive healthcare through Medicaid, yet two-thirds of providers don’t accept it. Brave Health is stepping up to close this gap by making mental health care accessible, affordable, and life-changing for all.

Job Overview

In this crucial role, you will manage the payor enrollment process, working closely with our Director of Credentialing Operations. You'll be a key contributor to our clinical onboarding and ongoing enrollment, ensuring that all clinical providers are efficiently enrolled and renewed with health plans. We’re seeking someone who thrives in a fast-paced environment, has an eye for process improvement, and is eager to explore innovative solutions-whether it's enhancing efficiency or leveraging new tools. The ideal candidate should be passionate about healthcare access.

Responsibilities

Provider Data Management & Credentialing

• Compile and maintain current and accurate data for all clinical providers.
• Manage credentialing documentation within databases, ensuring timely enrollment and re-credentialing.
• Perform primary source verification during initial credentialing and re-credentialing.
• Maintain copies of enrollment forms, applications, and other required documentation.
• Oversee and maintain payor enrollment delegation rosters, including updates for new hires and providers no longer employed by Brave Health.

Onboarding & Payor Enrollment

• Partner with HR to ensure new providers are fully enrolled in health plans before their start date.
• Assist new hires with Medicaid and Medicare applications, including reassigning Medicare benefits to Brave Health.
• Serve as a resource for new hires, addressing questions related to payor enrollment and credentialing processes.
• Ensure the submission of current credentialing documentation during onboarding for primary source verification.

Process Improvement & Vendor Management

• Collaborate with vendors to support payor enrollment processes.
• Research new payor enrollment opportunities to enhance network participation.
• Drive process and tool improvements, adapting to the growth and evolving needs of the organization.
• Identify areas for increased efficiency, including potential outsourcing or new technology implementations to streamline operations.

Qualifications

• Minimum of three years of relevant credentialing/payor enrollment experience required.
• Strong knowledge of Medicaid, Medicare, and private payer insurance systems.
• Highly organized with the ability to multitask and manage competing priorities effectively.
• Skilled at working under pressure and adapting to the fast-paced, evolving needs of a startup environment.
• Strong tools/automation orientation: proactive in seeking, evaluating, and recommending new technologies and tools to enhance scalability and efficiency.

Preferred Skills

• Certification by the National Association of Medical Staff Services (NAMSS) as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) is preferred.
• Preference for candidates with leadership experience in managing credentialing/payor enrollment teams or driving key process improvements.
• Associate’s or Bachelor’s degree in Healthcare, Business Administration, or a related field is preferred.
• Remote work experience is strongly preferred.

What We Offer

• Comprehensive health, dental, and vision coverage.
• Generous paid time off, including parental leave.
• Fully remote, work from home position; all equipment provided!