Senior Program Manager, Payer Operations

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

📋 Description

• Oversee the resolution of open payer issues from start to finish, ensuring accountability, visibility, and ownership throughout the process.

• Enhance revenue cycle management (RCM) efficiency and effectiveness to boost revenue performance while improving experiences for Alma providers and clients.

• Facilitate connections among stakeholders, subteams, and workflows across internal operations teams.

• Act as the primary operational liaison for Business Development (BD) counterparts, coordinating payer requirements, claims, rosters, complaints, and escalation matters.

• Engage in payer discussions alongside the Business Development Team to advance RCM topics and address issues.

• Keep abreast of payer requirements and mergers, proactively mobilizing internal teams to implement necessary changes.

• Monitor and report RCM performance by payer, identifying trends and risks while driving improvements.

• Achieve enhancements in portfolio RCM performance, meet payer performance goals, ensure timely payer initiatives, conduct payer health assessments/business reviews, and maintain stakeholder satisfaction.

⛳️ Requirements

• Background in healthcare operations with a solid understanding of insurance claims and payer relationships.

• Strong ability to collaborate cross-functionally without direct authority.

• Highly organized, with proven experience managing complex projects involving multiple stakeholders from inception to completion.

• Capacity to navigate ambiguity comfortably and proactively identify subsequent steps.

• Excellent communication skills to simplify operational complexities for both internal partners and external payer contacts.

• Detail-oriented and data-driven, capable of monitoring performance metrics and translating them into actionable strategies.

🏝️ Benefits

• Offers Equity.

• Health, Dental, and Vision benefits commence on your first day at Spring.

• One Medical accounts available.

• HSA and FSA plans, with Spring contributing up to $1K for HSAs depending on the selected plan type.

• Employer-sponsored 401(k) matching up to 2%.

• Annual allotment of no-cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents.

• Competitive paid time off policies, including vacation, sick leave, and company holidays.

• Parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents after 6 months of tenure.

• Access to Noom, a weight management program.

• Fertility care support through Carrot, plus reimbursement of up to $4,000 for related fertility expenses.

• Access to Wellhub for fitness, mindfulness, nutrition, and sleep resources.

• Access to BrightHorizons-sponsored child care, back-up care, and elder care.

• Up to $1,000 Professional Development Reimbursement per year.

• $200 per year in donation matching.