Health Plan Operations Manager at Cartwheel

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Full Time

Start Date

Immediate

Expiry Date

04 Feb, 26

Salary

115000.0

Posted On

06 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Behavioral Health, Telehealth, Payer Operations, Payer Contracting, Revenue Cycle Management, Group Contracting, Delegated Credentialing, Payer Enrollment, Health Plan Strategy, Analytical Thinking, Project Management, Collaboration, Licensing, Compliance, Infrastructure Development, Process Improvement

Industry

Mental Health Care

Description

Join Cartwheel to help tackle the student mental health crisis! Cartwheel is an early-stage company building a new kind of mental health program for kids that puts schools at the center. We see our role as supporting school staff who see kids every single day. Instead of going around them, we collaborate with them. This means: Earlier intervention Higher student and family engagement in care Better coordination among the trusted adults in a student’s life Kids shouldn't just aspire to get out of bed and drag themselves to class. They should be able to experience joy. They deserve to envision and build a life they’re excited to live. If you join Cartwheel, you’ll help make this vision a reality for millions of students across the country. We’re backed by top investors including A Street Ventures, Menlo Ventures, Reach Capital, General Catalyst, BoxGroup, and Able Partners, and we're looking for mission-driven teammates to join our team. ABOUT THE ROLE Cartwheel is rapidly growing in scale and complexity. Our Health Plan Operations Team is responsible for both the strategy and operationalization of how Cartwheel contracts and partners with payers. Cartwheel works with Medicaid, Managed Medicaid, and Commercial payers in 15 states. We expect this footprint to double over the next two years adding more states and payers. This role will lead strategic, growth, and process improvement projects across payer contracting, payer enrollment, and revenue cycle management operations. As Cartwheel’s Health Plan Operations Manager, you’ll provide strategic support to both the Director of Health Plan Operations and Sr. Manager of Revenue Cycle to expand and optimize how Cartwheel generates medical revenue. Role type: Full-time Role reports to: Director of Health Plan Operations Start date: Fall/Winter 2025 Location: Remote WHAT YOU’LL DO Partner with the Director of Health Plan Operations around Cartwheel's group contracting strategy and execution as we expand into new states and markets Lead Cartwheel’s delegated credentialing efforts to expedite provider enrollment with key payers–manage existing relationships, implement new contracts, and explore opportunities to expand delegation Build operational infrastructure around psychiatrist and nurse practitioner licensing and collaborations as well as multi-state practice strategy Partner cross-functionally to drive strategic projects for Health Plan Operations and Revenue Cycle. You will be working most closely with the People and Operations teams but will also engage with IT, Clinical, R&D, and others as well. This includes creating important analyses to inform key decisions, implementing new projects and tools, and analyzing and improving existing workflows and processes YOU ARE LIKELY TO BE A GOOD FIT IF You have management experience in a behavioral health, telehealth, or related field in the payer operations, payer contracting, and revenue cycle You have group contracting, delegated credentialing, payer enrollment, health plan strategy, and revenue cycle strategy experience in relevant environments (multi-state, behavioral health, telehealth) You are a highly analytical thinker and enjoy working in a culture that values structured logical reasoning (you’re equally at home in a google sheet, payer contract, Looker dashboard, billing system, etc.) Have experience building out payer operations and revenue cycle infrastructure within a growing organization You are highly accountable (e.g., you define clear outcomes, set deadlines, escalate risks, deliver) You embody our values: Human, Humble, Accountable, Innovative, Resilient BONUS POINTS FOR Looker, Salesforce, and Apero knowledge and experience Experience working directly with or for Medicaid and commercial payers Knowledge of behavioral health/healthcare regulations for billing, contracting, licensure, and compliance Multi-state behavioral health/healthcare experience and/or digital health experience COMPENSATION AND BENEFITS Mission-oriented and inclusive colleagues who will go to bat for you Competitive compensation between $95,000 - $115,000 Generous PPO medical, vision, and dental coverage Generous paid time off, including company closure from Christmas-New Years (12/25-1/1) 401(k) with 2% employer match Annual educational stipend In-person retreats Macbook Cartwheel is proud to be an equal opportunity employer. We embrace diverse backgrounds and perspectives and an inclusive work environment. We're committed to equal employment opportunity regardless of race, color, religion, ancestry, national origin, gender, sexual orientation, disability status, or veteran status. We participate in E-Verify. Please be prepared to provide acceptable documentation to verify your identity and work authorization

Responsibilities

Lead strategic, growth, and process improvement projects across payer contracting, payer enrollment, and revenue cycle management operations. Partner with the Director of Health Plan Operations to expand and optimize how Cartwheel generates medical revenue.