Senior Manager, Practice Operations

**ABOUT FINNI HEALTH** Finni Health helps BCBAs go independent. We provide the infrastructure for BCBAs to actually do it — credentialing, payer contracting, revenue cycle, HR, compliance, and the software that ties it together — so they can focus on delivering care to kids with autism instead of fighting insurance companies. We support practices across a dozen-plus states and are expanding into new ones every quarter. We're YC-backed, counted General Catalyst among our earliest investors, and are growing quickly in a market where families routinely wait months for services that should take days to start. We're a small team moving fast in a heavily regulated industry. That combination is the job.   **THE ROLE** A provider who is not enrolled with a payer can't deliver services. A session without an authorization can't be billed. Every week those two facts hold, a family waits longer than they should and a practice owner absorbs the cost. That is the kind of problem this role exists to close. As a Senior Manager, Practice Operations, you will be the trusted operator we point where our teams will benefit most. Practice Operations runs several functions that work today because a small number of experienced people carry them in their heads. Your job is to take one at a time, understand the current state, collaborate to design the ideal workflow, implement it with the team that will run it, prove it with numbers, hand it to a named owner, and then take the next one. **Your first assignment is credentialing and payer enrollment.**   **WHAT YOU WILL BE DOING** - **Assignment Ownership:** Take an operational problem from roughly defined to fully optimized. We will agree to the shape of the solution together; closing the rest of the design, sequencing it, and getting it adopted is yours. - **Process Design and Documentation:** Develop the operating procedures for a best-in-class team, end to end, with owners, timings and escalation paths. Living documents the team actually works from, not a binder nobody opens. - **Measurement and Reporting:** Define what we count and make sure the numbers are trustworthy. You own whether what we measure matters, not just whether the dashboard renders. - **Quality and Evidence:** Design and run the checks that confirm work was done accurately and on time, with proof attached and independently confirmed. - **Product Partnership:** Be the operations voice in Product. Translate what the team needs into specifications engineering can build, then verify the build actually solved the problem before it is called done. - **Adoption and Training:** Roll out what you build. Our operations team works across time zones, and adoption and execution are how we'll know the process works. - **Handoff and Sustainment:** Finish assignments properly. An assignment is complete when there is a named owner who is not you, a published metric that shows us it's working, written material the team actually works from, and a 60-day check-in confirming it all survives your transition. - **Cross-Functional Collaboration:** Work closely with credentialing, revenue cycle, product, practice success, HR and compliance to align operational changes with wider business objectives. - **Additional Responsibilities:** Adapt and take on evolving responsibilities and projects as Finni Health grows and our priorities shift. This is a role defined by what needs fixing, and that will continue to evolve.   **YOUR FIRST ASSIGNMENT: CREDENTIALING AND PAYER ENROLLMENT** A provider who is not enrolled with a payer can't deliver services, and a session without an authorization can't be billed. That seam sits between credentialing, which gets providers enrolled, and revenue cycle, which handles claims once they are clean, and nobody owns that gap today. Expect this assignment to take about six months. What we need built: - **Time to Enrolled** , meaning the days from a provider signing an offer to being enrolled with a given payer, published weekly and trusted. Underneath it: how quickly applications are submitted, how accurate the submissions are, the value of billing currently blocked by pending enrollments, and follow-up compliance. - **A per-payer requirements library** , so a submission goes out as soon as that payer's minimum is met instead of waiting on the strictest payer on the list. - **Evidence discipline.** Proof of network participation on file, because a note in someone's inbox cannot be used with a payer to push back on a denial. And the reverse case caught early: providers quietly dropped by a payer, before a practice owner hears it from someone else. - **Written submission process by state and payer** , specific enough that a coordinator who has never worked a given state can submit there. Today some coordinators have deep expertise in particular states and others do not know how to submit there at all. - **Backlog programs** run to a defined end, then prevented from recurring.   **WHAT COMES AFTER** Chosen with the Head of Practice Operations, based on what is needed. Projects could include improving prior authorizations, optimizing the onboarding process for new Practice Owners and staff, or building out a new internal function.   **ABOUT YOU** You are an operator rather than an advisor. You are happiest with a broken process, a set of data and a team that has been asking for someone to fix this. - **Experience:** 5+ years running operations in a complex, regulated environment where the work was messy and you were the one who cleaned it up. Healthcare strongly preferred, ideally multi-state. Early-stage startup, behavioral or mental health, or healthcare tech experience is a plus. - **Process Building:** Demonstrated expertise in identifying inefficiencies and building the fix, not only naming it. SOPs that got used, a workflow you designed, an SLA you set and then held a team to. - **Execution and Follow-Through:** A track record of finishing. Be ready to walk us through something you took from broken to boring, including how you handed it off and whether it held. - **Analytical and Problem-Solving:** Strong ability to work with operational data, identify trends and root causes, and implement data-driven solutions. You can define a metric, notice when a number looks wrong, and go find out why. - **Influence Without Authority:** Proven ability to get people who do not report to you to change how they work, and to do it without burning the relationship. - **Credentialing Exposure (Strongly Preferred):** Familiarity with provider credentialing or payer enrollment. CAQH, NPPES, PECOS, state Medicaid portals, commercial payer portals. You do not need to have run a credentialing team, but knowing where applications stall will make your first six months much easier. Prior authorization or utilization management experience is also valuable. - **Communication and Collaboration:** Excellent written and verbal communication, with proven ability to work across internal teams and with external stakeholders. Most of what this role produces is written and built so teams can actually use it. - **Tech Proficiency:** Proficient in Google Suite, Slack, and EHR or operational management tools. Experience writing requirements for a product or engineering team is a plus, as is experience working with offshore teams. - **Mission Alignment:** Passion for Finni's mission to democratize autism care and empower providers to run strong, compliant practices. - **Adaptability and Agility:** Comfortable thriving in a dynamic, fast-paced startup environment, embracing change, and navigating ambiguity with a proactive mindset.   **WHAT WE ARE NOT LOOKING FOR** Someone who wants to own a queue, or whose measure of a good year is headcount. If your instinct on being handed a broken process is to add people to it, this is the wrong role. Equally, if you want a finished plan to administer, this isn't what you're looking for.   **WHAT SUCCESS LOOKS LIKE** - **First 30 days:** You can tell us where the days actually go between offer signed and enrolled, and which payers and states cost us the most. You have sat with every credentialing group and with revenue cycle, know the problems, and have a clear plan to execute our solution. - **First 90 days:** The per-payer requirement library exists for our top payers by volume. Time to Enrolled is reported weekly and we trust the number, blocked billing is on a dashboard with a name against every line of it, and our metrics are headed in the right direction. - **First 6 months:** Blocked billing from enrollment is measurably down and the trend has turned. The process is documented and in use. A new coordinator can be trained from written material instead of by shadowing. The project is ready for turnover and has a handoff date. - **Months 7 to 9:** Assignment one has survived its 60-day check. Assignment two is scoped and underway.   **COMPENSATION AND LOCATION** - **$130,000 – $150,000** base salary, plus equity in what you build. - **Fully remote within the US.** Our operations team works across time zones, so some flexibility on hours is part of the job. - You'll report to **Jordan Hausman, Head of Practice Operations**.   **WHY FINNI** - Meaningful problems in behavioral healthcare — your work directly shortens the wait between a family needing autism care and a provider being able to deliver it. - Ownership from day one on a lean, execution-focused team. This role is scoped as a series of assignments you take from broken to boring, which means the evidence of your work is unusually visible. - You'll help write the playbook rather than administer someone else's. Practice Operations is being built now. - Supportive but high-expectation culture — we move with speed and intention. - Stock options: equity in what you build.   **HOW TO APPLY** In your application, tell us about a process you took from broken to boring. What state was it in when you got it, what you actually changed, who you had to bring along who didn't report to you, and what happened to it after you handed it off.   Finni Health is an equal opportunity employer. We consider qualified applicants without regard to any characteristic protected by applicable law. Reasonable accommodations are available throughout the hiring process. Visa sponsorship is not available for this role.