Director of Payor Operations
About Equip
Equip is the leading virtual, evidence-based eating disorder treatment program on a mission to ensure that everyone with an eating disorder can access treatment that works. Created by clinical experts in the field and people with lived experience, Equip builds upon evidence-based treatments to empower individuals to reach lasting recovery. All Equip patients receive a dedicated care team, including a therapist, dietitian, physician, and peer and family mentor. The company operates in all 50 states and is partnered with most major health insurance plans. Learn more about our strong outcomes and treatment approach at www.equip.health.
Founded in 2019, Equip has been a fully virtual company since its inception and is proud of the highly-engaged, passionate, and diverse Equisters that have created Equip’s culture. Recognized by Time as one of the most influential companies of 2023, along with awards from Linkedin and Lattice, we are grateful to Equipsters for building a sustainable treatment program that has served thousands of patients and families.
About the role
The Director of Payor Operations will be responsible for building and leading the operational infrastructure that enables high-quality, compliant, and scalable care delivery across Equip’s commercial and Medicaid health plan partnerships. This role will sit at the intersection of Payor Partnerships, Care Delivery, Legal, and Finance to translate health plan contract requirements into day-to-day execution, ensuring we deliver care in accordance with contractual requirements while optimizing access and reimbursement.
Responsibilities
Partner with cross functional leaders to ensure internal processes and care delivery are in accordance with health plan needs across commercial and Medicaid lines of business
Translate health plan contracts, provider manuals, and regulatory requirements into scalable operational workflows
Serve as the internal subject-matter expert on credentialing and payor operational requirements
Oversee the Credentialing team to ensure providers are enrolled, credentialed, and re-credentialed across all contracted payors, including Medicaid, in a timely and compliant manner.
Partner cross-functionally with various teams including Care Delivery, Care Operations, Payor Partnerships, Revenue Cycle, and Legal to ensure operational readiness and alignment with existing payor contract obligations, current and new regulatory requirements, and new payor implementations and market expansion.
Provide operational insight and data to support payor performance discussions and contract optimization.
Establish KPIs and develop reporting mechanisms to track performance for credentialing and overall payor operations.
Identify operational risks and process inefficiencies and lead remediation efforts as needed.
Support payor audits, payor reviews, and regulatory or compliance inquiries as needed.
Perform other duties as assigned.
Qualifications
8+ years of experience in payor operations, managed care operations, or healthcare administration.
Demonstrated experience and expertise with commercial health plans and Medicaid, including regulatory and compliance requirements.
Proven leadership experience managing operational teams in a fast-paced environment.
Strong cross-functional collaborator who can partner effectively with clinical and operational stakeholders.
Experience in healthcare startups or high-growth environments strongly preferred.
Ability to translate complex contracts and regulations into clear, executable workflows.
Time Off:
Flex PTO policy (3-5 wks/year recommended) + 11 paid company holidays.
Generous parental leave.
Core Benefits:
Competitive Medical, Dental, Vision, Life, and AD&D insurance.
Equip pays for a significant percentage of benefits premiums for individuals and families.
Spring Health, a 100% employer-paid mental health benefit through Guardian.
You can receive 5 free therapy sessions and 5 free coaching sessions per year for you and each of your dependents.
Employee Assistance Program (EAP), a company paid resource for mental health, legal services, financial support, and more!
HealthJoy, a 100% employer-paid platform connecting you to a healthcare concierge who can help you navigate your benefits.
401K Option!
Work From Home Additional Perks:
$50/month stipend added directly to an employee’s paycheck to cover home internet expenses.
$250/month stipend to use a co-working space.
Initial work-from-home stipend of up to $500.
Reload of $200 on the home office stipend at the 3-year mark and then every other year after that (year 5, year 7, etc.).
Company Laptop.
Physical Demands
Work is performed 100% from home with no requirement to travel. This is a stationary position that requires the ability to operate standard office equipment and keyboards as well as to talk or hear by telephone. Sit or stand as needed.
At Equip, Diversity, Equity, Inclusion and Belonging (DEIB) are woven into everything we do. At the heart of Equip’s mission is a relentless dedication to making sure that everyone with an eating disorder has access to care that works regardless of race, gender, sexuality, ability, weight, socio-economic status, and any marginalized identity. We also strive toward our providers and corporate team reflecting that same dedication both in bringing in and retaining talented employees from all backgrounds and identities. We have an Equip DEIB council, Equip For All; also referred to as EFA. EFA at Equip aims to be a space driven by mutual respect, and thoughtful, effective communication strategy - enabling full participation of members who identify as marginalized or under-represented and allies, amplifying diverse voices, creating opportunities for advocacy and contributing to the advancement of diversity, equity, inclusion, and belonging at Equip.
As an equal opportunity employer, we provide equal opportunity in all aspects of employment, including recruiting, hiring, compensation, training and promotion, termination, and any other terms and conditions of employment without regard to race, ethnicity, color, religion, sex, sexual orientation, gender identity, gender expression, familial status, age, disability, weight, and/or any other legally protected classification protected by federal, state, or local law.
Our dedication to equitable access, which is core to our mission, extends to how we build our "village." In line with our commitment to Diversity, Equity, Inclusion, and Belonging (DEIB), we are dedicated to an accessible hiring process where all candidates feel a true sense of belonging. If you require a reasonable accommodation to complete your application, interview, or perform the essential functions of a role, we invite you to reach out to our People team at accommodations@equip.health.
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