Compliance Specialist
Our mission: to eliminate every barrier to mental health.
Spring Health is the leading comprehensive mental health benefit for employers. We help employees understand their mental health issues and connect with best-in-class providers to get the right treatment at the right time.
From early detection to full recovery, Spring Health is the only clinically validated solution in the market proven to be more effective than traditional mental healthcare. By combining the latest technology with vetted providers, we help engage 1 in 3 employees, reduce recovery times, and lower healthcare costs. We are an award-winning, passionate, and mission-driven team with the support of leaders in psychiatry. We have raised over $300 million to date from prominent investors including Kinnevik, Tiger Global, Northzone, RRE Ventures, Rethink Impact, Work-Bench, William K Warren Foundation, SemperVirens, Able Partners, True Capital Ventures, and a strategic investor Guardian Life Insurance. Thanks to their partnership, our current valuation has reached $2 billion.
We are looking for a Quality Specialist to join our team that will report directly to the Quality & Compliance Manager. You will be focused on implementing quality and compliance initiatives created by the Health Plan Operations Department.
What you’ll be doing:
- Run the day to day aspects of the provider credentialing program modeled after NCQA, and TJC credentialing standards.
- Prepare and maintain provider credentialing profiles.
- Assist providers with the credentialing process including provider outreach for missing information in credentialing applications.
- Verifying provider credentials using Primary Source Verification methods for both initial credentialing and recredentialing.
- Document ongoing monitoring of providers through OIG, and SAM’s portals, etc.
- Maintains digital copies of current state license, malpractice coverage, DEA certificates and any other required documentation; ensuring timely renewals.
- Create provider online profiles using an approved credentialing database.
- Assists with credentialing audits by payers, state and/or federal agencies.
- Identify credentialing trends or red flags and report them to the Quality & Compliance Manager.
- Compile and submit required documentation for delegated and non-delegated health plan contract credentialing and recredentialing.
- Assist with other ad hoc operational efficiency projects as needed by the Quality and Compliance Manager
What we expect from you:
- At least (2-3) years of working experience in provider credentialing.
- Comfortable in rapidly changing environments and with constantly evolving responsibilities.
- Tech-savvy: very comfortable adopting new technologies and platforms and efficient in tech-related tasks.
- Excellent written and verbal communication skills.
- Able to multi-task and context switch!
- Bonus: Bachelor's Degree in Health Administration, Public Health, or Business Administration
Why you'll like working at Spring Health:
- Big mission: we're revolutionizing the mental health industry
- The challenge: make a big impact by joining a fast-growing team in its early stages
- Good benefits: we offer health, dental and vision benefits as well as access to mental health care on Spring Health
- Great people: make an impact on something that truly helps people alongside an incredible team
- We care about diversity: diversity allows us to build an excellent patient experience. We are an equal opportunity employer and we do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status
In addition to finding people who are truly excellent at what they do, we take our values at Spring Health seriously:
Members Come First We are genuine member advocates.
Move Fast to Change Lives We build with urgency and intention.
Take Ownership We extend trust and hold ourselves accountable.
Embrace Diverse Teams & Perspectives We find strength in the diversity of cultural backgrounds, ideas, and experiences.
Science Will Win We will achieve impact by innovation and evidence based frameworks.
Candor with Care We are open, honest and empathetic.
Spring Health is proud to be an equal opportunity employer. We do not discriminate in hiring or any employment decision based on race, color, religion, national origin, age, sex, marital status, ancestry, disability, genetic information, veteran status, gender identity or expression, sexual orientation, or other applicable legally protected characteristic. We also consider qualified applicants regardless of criminal histories, consistent with applicable legal requirements. Spring Health is also committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. If you have a disability or special need that requires accommodation, please let us know.
#LI-Remote