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Remote Healthcare Operations Analyst

πŸ•’ 21 days ago
Healthcare OperationsClinician CredentialingPayer EnrollmentInsurance Verification
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πŸ“œ Description

  • Build systems and metrics to monitor virtual care quality and flag potential care issues.
  • Lead clinician credentialing, state registration verification, and payer enrollment workflows.
  • Create dashboards and audit processes to track care quality, licensing, credentials, and compliance.
  • Identify automation opportunities and optimize scheduling, communication, and other operational workflows.
  • Develop backend systems that support multi-state growth while limiting manual work and overhead.

πŸ› οΈ Requirements

  • 5-8 years of healthcare operations experience, including at least 3 years in U.S.-based credentialing, payer enrollment, and insurance verification.
  • Hands-on experience with major payer systems such as Blue Cross or Anthem and credentialing across provider types.
  • Experience implementing workflow optimization, process improvement, or quality assurance in healthcare or a regulated environment.
  • Experience building operational metrics and KPI dashboards in regulated healthcare.
  • Able to independently identify problems and design backend operations solutions with minimal supervision.
  • Demonstrated success automating or streamlining manual processes.
  • English proficiency at C1+ CEFR level.
  • Nice to have: mental health, behavioral health, telehealth, AI or automation tools, startup operations, multi-state compliance, or KPI dashboard experience.

✨ Benefits

  • Competitive Salary: Based on experience and skills
  • Remote Work: Fully remoteβ€”work from anywhere
  • Team Incentives: Recognition for maintaining 100% CRM hygiene and on-time reporting
  • Generous PTO: In accordance with company policy
  • Health Coverage for PH-based talents: HMO coverage after 3 months for full-time employees
  • Direct Mentorship: Guidance from international industry experts
  • Learning & Development: Ongoing access to resources for professional growth
  • Global Networking: Connect with professionals worldwide
  • Design patient intake workflows for documentation, insurance verification, and financial obligations.
Full job description

Work From Anywhere in LATAM and the Philippines

Work Schedule: US Timezone (Flexible) | Overlap with US business hours

About Pearl Talent

Pearl works with the top 1% of candidates from around the world and connects them with the best startups in the US and EU. Our clients have raised over $5B in aggregate and are backed by companies like OpenAI, a16z, and Founders Fund. They're looking for the sharpest, hungriest candidates who they can consistently promote and work with over many years. Candidates we've hired have been flown out to the US and EU to work with their clients, and even promoted to roles that match folks onshore in the US.

Hear why we exist, what we believe in, and who we're building for: Watch here: https://www.loom.com/share/863b8e426e6d48309aa8f4ea4c1c94cd

About the Client

A rapidly scaling telehealth mental health practice is preparing to expand into multiple new states and needs an Operations Project Associate to build and optimize the systems that enable quality care delivery at scale. The organization has grown to serve millions of patients virtually but recognizes that operational infrastructure and compliance frameworks need to catch up to the technology.

The company operates a distributed model with therapists across multiple states and is backed by leadership with deep healthcare and venture expertise. What makes them notable is their focus on ensuring care quality remains constant as the patient base and clinician network scaleβ€”a problem that most telehealth platforms haven't solved.

The role exists because mental health telehealth creates a unique challenge: when therapist-client sessions happen in isolation without direct oversight, how do you ensure quality care is being delivered and identify when something's wrong? This requires building processes, dashboards, and accountability systems that were never designed for a virtual-first model.

About the Role

As Operations Project Associate, you'll architect the backend systems that make quality mental health care possible at scale. You won't interact with clinicians day-to-day or manage patients directly. Instead, you'll work autonomously on internal operations projects, designing workflows that optimize patient intake, building credentialing systems that work across multiple states and payers, and creating quality assurance frameworks that catch problems before they become crises. Success means operational systems that enable oversight without impeding clinical relationships, while preparing the company to scale efficiently into new markets.

Core Responsibilities

Patient Care Workflow Optimization

  • Design and implement efficient patient intake processes that cover documentation, insurance verification, and financial obligation determination
  • Build systems to track care quality in virtual environments and establish metrics that identify discrepancies between patient self-reporting and clinician assessments
  • Create processes that flag when proper care may not be delivered and trigger appropriate coaching or accountability measures
  • Leverage AI and telehealth technology to maintain quality standards as patient volume increases

Clinician Onboarding & Credentialing

  • Lead credentialing workflows including state registration verification and insurance provider enrollment across multiple payers
  • Collect and organize payer-specific information required by major insurers (Blue Cross, Anthem, etc.) for payment processing
  • Design onboarding systems that ensure all compliance and administrative requirements are met before clinicians see patients
  • Build dashboards that track licensing, credentials, and payer enrollment status across multiple states in real time

Quality Assurance & Audit

  • Implement managed-based care frameworks to track patient progress and care effectiveness over time
  • Design audit processes suited to the telehealth context that surface misalignments between patient outcomes and clinician notes
  • Create accountability systems that use objective metrics to ensure clinicians deliver appropriate care
  • Develop KPI dashboards that enable leadership to monitor quality and compliance across the organization

Process Automation & System Optimization

  • Identify automation opportunities across all operational workflows to reduce manual work as the company scales
  • Streamline client scheduling, communication, and service retention using existing tools
  • Implement technology solutions that increase efficiency without requiring new platform purchases
  • Optimize backend systems to support multi-state growth without proportional increases in operational overhead

Requirements

Must-Have

  • 5-8 years of healthcare operations experience with minimum 3 years in U.S.-based systems involving credentialing, payer enrollment, and insurance verification workflows
  • Hands-on experience with major payer systems (Blue Cross, Anthem, or equivalent) and demonstrated understanding of how credentialing works across different provider types
  • Proven track record designing and implementing workflow optimization, process improvement, or quality assurance initiatives in healthcare or similarly regulated environments
  • Experience building systems or dashboards to track operational metrics and performance KPIs in a regulated healthcare setting
  • Demonstrated autonomy working on backend operations projects with minimal supervision; ability to identify problems and design solutions independently
  • Automation mindset with concrete examples of streamlining manual processes, identifying efficiency opportunities, or implementing technology solutions to reduce manual work
  • English at C1+ CEFR level for clear communication with U.S.-based leadership and creation of operational documentation

Nice-to-Have

  • Mental health, behavioral health, or telehealth operations experience (skills transfer from general healthcare operations)
  • Experience implementing AI tools, automation platforms, or workflow optimization software in healthcare settings
  • Background working at scaling startups or mid-market healthcare organizations (50-500 employees) where you built systems from scratch
  • Familiarity with multi-state healthcare operations and state-level licensing, compliance, or regulatory requirements
  • Dashboard and KPI development experience using data to identify operational problems and measure improvement

Benefits

  • Competitive Salary: Based on experience and skills
  • Remote Work: Fully remoteβ€”work from anywhere
  • Team Incentives: Recognition for maintaining 100% CRM hygiene and on-time reporting
  • Generous PTO: In accordance with company policy
  • Health Coverage for PH-based talents: HMO coverage after 3 months for full-time employees
  • Direct Mentorship: Guidance from international industry experts
  • Learning & Development: Ongoing access to resources for professional growth
  • Global Networking: Connect with professionals worldwide

Our Recruitment Process

  1. Application
  2. Screening
  3. Skills Assessment
  4. Topgrading Interview
  5. Client Interview
  6. Job Offer
  7. Client Onboarding

Ready to Join Us?

If you’re empathetic, organized, and passionate about improving patient experiences through operational excellence, this role is for you. Apply now to help make specialized healthcare more accessible to patients across the U.S.

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