Senior Manager, Contracting & Credentialing
2 days ago
New York
Job DescriptionAbout Sunrise Group Sunrise Group is building the future of sleep health by combining breakthrough technology with expert care. We started in 2015 with a straightforward idea: sleep diagnosis should happen in the comfort of your own home, not in a hospital. To make that possible, we created a first-of-its-kind chin sensor, carefully validated through clinical research, reviewed by leading sleep experts, and cleared by the FDA. Since then, Sunrise Group has grown from a single innovation into a complete sleep health company. We now design advanced diagnostic and treatment solutions, and we deliver care directly to patients through Dreem Health, our digital sleep clinic. By serving patients in all 50 states with reimbursed care, we are making sleep treatment more accessible, more personal, and much simpler than it has ever been. Your Opportunity The Senior Manager of Contracting & Credentialing is a strategic and operational leader responsible for overseeing provider credentialing, provider licensing, payer contracting, and network expansion across multiple states for a growing telehealth sleep medicine organization. This role requires deep expertise in multi-state credentialing, payer enrollment, government programs (Medicare/TriCare), and third-party vendor management, with a strong understanding of reimbursement and compliance. This role is critical to enabling scalable growth, payer access, and regulatory compliance in a complex, multi-state telehealth environment. The Senior Manager will directly influence provider onboarding speed, payer coverage, revenue integrity and long-term network strategy with direction from the Direction of Managed Care Contracting. The ideal candidate is CPC-certified, highly organized, data-driven, and experienced in scaling provider networks while maintaining compliance with federal, state, and payer requirements. What You'll Do Credentialing & Provider Enrollment • Lead end-to-end provider credentialing, provider licensing and recredentialing for MDs and NPs, and any additional allied clinicians across multiple states, • Oversee CAQH, PECOS, Medicare, and commercial payer enrollment, • Ensure compliance with state licensure, scope of practice, supervision, and collaborative practice requirements, • Maintain credentialing records, expiration tracking, and audit-ready documentation, • Lead payer contracting strategy across commercial, Medicare Advantage, and government payers with direction from Director of Managed Care Contracting, • Negotiate and evaluate fee schedules, reimbursement rates, and contract terms, • Support payer expansion strategy aligned with business growth, market demand, and clinical capabilities, • Coordinate contracting for multi-entity, multi-TIN structures, • Oversee Medicare enrollment and compliance (PECOS, reassignment, revalidation), • Support state-specific government program participation, • Ensure adherence to CMS, No Surprises Act, and payer regulatory requirements, • Manage relationships with credentialing and contracting vendors, • Define SLAs, workflows, and performance expectations, • Audit vendor work for accuracy, timeliness, and compliance, • Partner closely with Compliance, Legal, Finance, Product, Clinical Leadership and Sales/Marketing/Business Development, • Support product and dev teams with credentialing and payer data requirements (APIs, system builds), • Provide reporting and dashboards on credentialing status, payer growth, and risk areas, • Prepare materials for board, compliance committee, and executive review What You Bring, • CPC Certification (required), • 7+ years of experience in provider credentialing, payer contracting, or provider enrollment, • Proven experience with multi-state credentialing and telehealth operations, • Strong knowledge of Medicare/PECOS, commercial payers, and government programs, • Experience managing third-party credentialing and contracting vendors Familiarity with sleep medicine, DME, or specialty care preferred, • Strong understanding of provider reimbursement and fee schedules, • Exceptional organizational, communication, and stakeholder-management skillsWhat Makes You Stand Out, • Experience in a telehealth or virtual care environment, • Knowledge of AASM, ACHC, or similar accreditation standards, • Experience supporting API-driven or data-centralized credentialing systems, • Meaningful work that directly improves peoples' lives, • Be part of an international team across the US, France, Belgium, • Annual company offsite, • Comprehensive health benefits (medical, dental, vision), • FREE One Medical membership, • 401(k) with company match, • 20 days PTO + 10 paid holidays + 80 hours paid sick leave We hire humans, not bullet points. Don't meet every single qualification? That's okay. We care more about who you are than what's on your CV. We're looking for people who are curious, resourceful, and ready to roll up their sleeves — especially if you're excited about building something new in healthcare. So if you think you could make an impact here, reach out to us. Dreem Health / Sunrise is an Equal Opportunity Employer. We welcome people of all backgrounds and are committed to building a workplace where everyone feels included and respected. We do not tolerate discrimination or harassment of any kind.