Insurance Directory Optimization Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Take ownership of Legion’s provider-directory accuracy and growth metrics across all contracted payers and networks, states, clinicians, service locations, specialties, and member-facing directory surfaces.

• Develop and uphold the definitive provider-data source of truth, encompassing clinician legal and display names, Type 1 and Type 2 NPIs, group affiliations, taxonomy codes, licenses, specialties, service locations, telehealth eligibility, accepting-new-patients status, contact information, booking URLs, payer participation, last verification date, owner, status, and supporting evidence.

• Reconcile the source of truth with NPPES, CAQH, credentialing rosters, payer portals, third-party aggregators, and internal provider and contracting systems; establish source precedence for each field to ensure discrepancies are consistently addressed.

• Create a comprehensive baseline inventory and risk-ranked remediation backlog, prioritizing missing providers, inactive or departed providers, incorrect locations, absent telehealth indicators, inaccurate specialties, duplicate records, broken links, phone-only calls to action, and high-volume payer opportunities.

• Audit each directory from a patient’s perspective: search by ZIP code, state, plan, specialty, telehealth, availability, and accepting-new-patients filters; ensure Legion appears in expected results and that each profile is accurate, complete, and actionable.

• Confirm that telehealth filters, virtual-visit tags, map pins, specialty mappings, language fields, appointment availability, and accepting-new-patients indicators function properly across desktop and mobile directory experiences where applicable.

• Submit corrections through the appropriate payer workflow—portal, roster file, API, secure email, ticket, or escalation—and track submission date, confirmation number, payer owner, promised service level, follow-up date, publication date, and member-side verification. A fix is not considered complete until it is live and independently verified.

• Standardize naming conventions, address formatting, phone numbers, credentials, taxonomy and specialty mappings, group affiliations, telehealth designations, and URL structure; create validation rules and a clear exception log.

• Collaborate with payer directory and network-operations teams to enhance Legion’s legitimate search prominence through precise category mapping, telepsychiatry and virtual-care terminology, featured or virtual-visit badges, complete profile fields, and accurate filter eligibility.

• Replace phone-only or generic calls to action with direct Legion landing pages, self-scheduling links, or SMS short codes wherever payer rules and directory capabilities permit.

• Create and manage unique UTM-tagged links by payer, network, directory, state, and placement; maintain a consistent naming convention, redirect ownership, destination QA, and documentation to ensure attribution remains intact through future updates.

• Partner with Growth and Engineering to develop payer- and state-aware landing experiences, synchronize insurance and availability messaging, reduce intake abandonment, and A/B-test calls to action, trust signals, scheduling flows, and page content.

• Instrument and validate the directory funnel in PostHog or comparable analytics from directory referral through eligibility, intake, scheduling, completed first visit, retention, and reactivation; maintain event definitions and investigate attribution gaps.

• Generate weekly reports covering inventory completeness, percentage of error-free listings, search visibility coverage, corrections initiated and resolved, aging by payer, clicks, intakes, scheduled visits, completed visits, conversion rates, and attributable revenue.

• Quantify the incremental patient volume and revenue unlocked by each significant directory fix; maintain an opportunity model that ranks the backlog by expected impact, confidence, effort, and time to resolution.

• Conduct monthly sweeps and lightweight automated monitoring to identify payer regressions, roster drift, broken URLs, status changes, duplicate records, and unexpected search-result changes before they negatively impact patients or revenue.

• Integrate provider launches, departures, license changes, new payer contracts, new states, address changes, taxonomy updates, and scheduling changes into a documented change-management workflow with designated owners and service levels.

• Develop payer contact maps, escalation paths, reusable outreach templates, roster-submission checklists, evidence standards, SOPs, and a decision log to ensure the operating system is auditable, repeatable, and transferable.

⛳️ Requirements

• A minimum of 2 years in provider-data management, payer or network operations, credentialing, revenue-cycle operations, healthcare data quality, growth operations, or a closely related field.

• Direct experience in updating payer directories, provider-finder tools, or network rosters through platforms such as Availity, CAQH, HealthSmart, payer-specific portals, delegated roster workflows, or third-party directory vendors.

• Strong knowledge of Type 1 and Type 2 NPIs, NPPES, CAQH ProView, taxonomy codes, specialties, group affiliations, service locations, telehealth designations, accepting-new-patients status, and network participation.

• Experience in diagnosing discrepancies across multiple systems, identifying the authoritative source, documenting the root cause, and verifying the member-facing correction post-publication.

• Advanced proficiency in Google Sheets or Excel, including handling large CSVs, XLOOKUP or VLOOKUP, INDEX-MATCH, pivot tables, data validation, deduplication, conditional formatting, normalization, and reconciliation.

• Familiarity with lightweight SQL, APIs, JSON or XML, SFTP roster files, scripts, or no-code automation; while you don’t need to be a software engineer, you should be capable of minimizing repetitive tasks.

• Experience with UTM conventions, redirect QA, PostHog or similar product analytics, funnel reporting, and conversion-rate measurement.

• Ability to navigate across portals, spreadsheets, email, phone, ticketing systems, and ambiguous payer processes while maintaining meticulous evidence and follow-up discipline.

• Excellent written and verbal communication skills. You can draft a clear escalation, request specific files or field definitions from a payer representative, and articulate the patient and revenue implications of an unresolved issue.

• Strong quality-control instincts. You can identify a single transposed digit, inconsistent taxonomy mapping, outdated address, missing virtual-care tag, or suspicious duplicate—and you will investigate until the record is accurate.

• Sound healthcare and privacy judgment. You can manage provider and network data while respecting access controls, minimum-necessary practices, payer regulations, and Legion’s compliance requirements.

• Low ego, high urgency, and a sense of end-to-end ownership. You measure success based on accurate live listings and completed visits, not merely activity, submitted forms, or closed spreadsheets.

🏝️ Benefits

• Performance Bonus: Additional compensation linked to strong outcomes such as verified listing accuracy, correction cycle time, directory-sourced booked visits, and measurable revenue impact.

• Contract Structure: Independent contractor (1099).

• Time Commitment: Approximately 20–40 hours per week.

• Initial Term: 3-month project, with renewal based on results and business needs.

• Work Hours: Flexible, with planned overlap for U.S. payer and internal-team coordination.

• Work Setup: Remote.

• Tools: PostHog, analytics dashboards, Google Sheets or Airtable, payer portals, CAQH, NPPES, roster files, APIs, and automation tools.

• Impact: Each accurate, discoverable listing aids a patient in finding in-network psychiatric care more quickly and transforms an invisible operations fix into tangible clinical and business value.

• Growth Opportunities: As the program expands, this role can evolve into broader provider-data governance, payer operations, credentialing systems, or growth-operations ownership.