Spring Health is hiring a Manager, Payer Integrations to oversee our payer integration portfolio and own performance for the CSN book of business. You will lead a team of Payer Integration Managers, driving high-quality, on-time integrations with health plans and TPAs. Your work will build cross-functional processes to accelerate implementations, reduce DSO, and increase clean-claim rates.
What You'll Do
- Own a portfolio of payer integrations, driving clean claims, faster payments, and improved accuracy across systems.
- Set and achieve key metrics including clean-claim rate, denial reductions, DSO, and launch timelines.
- Lead and grow a team of Payer Integration Managers, fostering clarity, development, and accountability.
- Prioritize and resource a high-impact pipeline of integrations and escalations based on business risk and revenue.
- Manage end-to-end payer launches—requirements, testing, and workflows across EDI, benefits, portals, and more.
- Identify and resolve barriers in claims logic, provider data, and configuration to ensure seamless adjudication.
- Partner across Billing, Benefits, Legal, and more to create repeatable playbooks and system-wide solutions.
- Build and evolve a payer KPI dashboard to monitor and optimize performance.
- Represent Spring Health with payers, building strong relationships and aligning on implementation and operations.
- Drive automation, tooling, and process improvements to reduce manual work and accelerate cycle time.
- Lead special projects as needed, translating learnings into scalable, evergreen practices.
What We're Looking For
- 5+ years of relevant experience in payer integrations/relations, healthcare implementation, or RCM within payer/provider ecosystems.
- 2+ years of experience directly managing a team, with demonstrated success in coaching, developing talent, and driving team performance in a fast-paced, cross-functional environment.
- Expert knowledge of payer operations and claims adjudication, including benefit design, funding structures, eligibility, and payment workflows.
- Hands-on expertise with HIPAA/ EDI (837, 835, 270/271), clearinghouses, payer portals, roster/CAQH workflows, EFT/ERA.
- Demonstrated success leading integration projects end-to-end—planning, execution, testing, launch—with measurable KPI improvements (DSO reduction, denial reduction, clean-claim success).
- Advanced analytical and problem-solving skills; ability to identify integration risks and craft innovative mitigation strategies.
- Exceptional communication and stakeholder management across technical and non-technical audiences; adept at presenting findings to senior leadership.
Nice to Have
- Bachelor’s degree in Health Information Management Systems (HIMS) or related field; Certified EDI Professional (CEP) or similar credentials.
- Experience with behavioral health, multi-state provider networks, and regulatory/compliance standards.
- Familiarity with Looker/BI, workflow tools (Asana/Jira), and integration platforms (e.g., Apero or similar).
Technical Stack
- HIPAA/ EDI (837, 835, 270/271)
- Clearinghouses
- Payer portals
- Looker/BI
- Workflow tools (Asana/Jira)
- Integration platforms (e.g., Apero)
Team & Environment
You will lead a growing team of Payer Integration Managers and report to the Director, Payer Revenue Programs.
Benefits & Compensation
- Compensation: $97,325 - $114,500 + equity via stock options.
- Health, Dental, Vision benefits start on your first day.
- Access to One Medical accounts.
- HSA and FSA plans available, with Spring contributing up to $1,000 for HSAs.
- Employer sponsored 401(k) match of up to 2%.
- Yearly 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.
- At 6 months tenure, parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents.
- Access to Noom, a weight management program.
- Access to fertility care support through Carrot, plus $4,000 reimbursement for related fertility expenses.
- Access to Wellhub for fitness, mindfulness, nutrition, and sleep.
- Access to BrightHorizons for sponsored child care, back-up care, and elder care.
- Up to $1,000 Professional Development Reimbursement a year.
- $200 per year donation matching to support your favorite causes.
Work Mode
This is a remote position.
Spring Health is proud to be an equal opportunity employer. They 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, pregnancy, or other applicable legally protected characteristic.
