Director, Qualification Engagement

The role

The Director, Qualification Engagement will own how specialist qualification is explained, how decisions are delivered, and how practices experience the process. This individual contributor role manages qualification decision communications, practice education, and qualification process operations.

What you will do

• Deliver qualification, requalification, and standing-change decisions to practices and specialists.
• Translate Qualification Committee reasoning into clear written and verbal communication.
• Own the adverse-finding workflow including documentation requests and tracking responses.
• Handle pushback with composure and consistency.
• Maintain the correspondence record for auditing.
• Build and maintain the practice-facing explanation of qualification.
• Lead qualification overview conversations with prospective and newly contracted practices.
• Set the qualification standard for Provider Success Managers.
• Communicate guideline changes to affected practices and specialists.
• Own the workflow from Committee decision to delivered communication.

Required qualifications

• Bachelor's degree or equivalent professional experience.
• Credibility with surgeons.
• Clinical career as a physician, surgeon (MD or DO), or other licensed clinician, or ten or more years in medical staff services, credentialing leadership, payer provider network, provider relations ma
• Exceptional communication.
• High emotional intelligence and judgment.
• Clinical literacy.
• Independent problem solving and project management.
• Comfort with data and tools.
• Integrity under pressure.
• Leadership and influence.

Nice to have

• Hold a credentialing or medical staff certification (for example CPCS or CPMSM through NAMSS)
• Direct experience communicating adverse credentialing or peer review determinations to physicians
• Built enablement or training materials for field or account teams
• Experience beyond direct patient care such as medical directorship, utilization or peer review, committee or quality work, or clinical research
• Presented to employer benefits leaders, consultants, or health plan audiences
• Energized by building a function from the ground up

Benefits

• Medical Insurance
• Dental Insurance
• Vision Insurance
• Short & Long Term Disability
• Life Insurance
• 401k with company match
• Paid Time Off
• Paid Parental Leave

About the company

Lantern is a specialty care platform that connects people with a Network of Excellence of top specialists for surgery, cancer care, and infusions. The company delivers care with cost savings to employers and pairs members with dedicated care teams.