Twentyeight Health
Twentyeight Health (www.twentyeighthealth.com) is a mission-driven women's health platform that provides telemedicine, medication delivery, and care coordination in Spanish and English. Our vision is to address health equity by providing high-quality, convenient, and affordable women’s health services designed to be inclusive of underserved communities.
Today, we are active in 50 states + DC and have exciting growth plans. We are rapidly expanding our offerings, and we are backed by some of the best healthcare & consumer investors pioneering digital health, including Third Prime, Town Hall Ventures, SteelSky Ventures, Foreground Capital, Seae Ventures, Impact America Fund, and more.
You’ll be joining a dynamic, supportive and mission-driven environment. We are a team of doctors, public health experts, designers, engineers and builders across the US committed to changing the face of healthcare, particularly for underserved communities.
At Twentyeight Health, we value a diverse workplace and strongly encourage women, BIPOC, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply. We are committed to fostering a culture of mutual respect, diversity and inclusion for our employees and customers alike and we can’t wait for you to be a part of it.
Role
Twentyeight Health is seeking a Director of Payer & Provider Operations to lead and scale the operational foundation behind our Enterprise growth. We are becoming an insurance-first company and are in a period of hypergrowth: we are growing Enterprise payer-covered consult volume roughly 2.5x by the end of 2026 and 5x by mid-2027 alongside our asynchronous care.
This individual will make sure provider supply and in-network coverage never limit that growth: growing the plans we are in-network with, making sure the right providers are available at the right time for every plan and state, and keeping our revenue cycle seamless, all done cost-effectively so that each new unit of growth takes less manual work than the last.
The role sits at the intersection of healthcare delivery, payer operations, and business performance. The ideal candidate is a highly strategic, deeply analytical healthcare operator who understands the complexities of insurance-enabled care, can study our business model to find what breaks at 2x,5x and 50x volume, and can build the foundation for growth while we keep flying the plane. You will join a strong, proven execution team across payer operations, provider operations, and revenue cycle, backed by strong partners in product, engineering, marketing, and clinical leadership.
This role will be reporting to the COO. You will lead our Payer Operations, Provider Operations, and Revenue Cycle leads and their teams, partner closely with clinical leadership, who own clinical quality and clinical decisions, and work alongside our CEO, who owns payer partnership relationships, by running the operational side of those partnerships.
Responsibilities
Clinical Operations
- Own provider capacity planning, forecasting, and surge planning across synchronous and asynchronous care, by plan, state, and visit type, so supply stays ahead of Enterprise demand.
- Lead the operating model for synchronous and asynchronous appointments, including provider templates and scheduling, real-time eligibility checks at booking, no-show and late-cancel handling, and one source of truth for provider calendars.
- Partner with clinical leadership to improve true consult success, provider utilization, and productivity, and to meet our access standards: 24-hour turnaround on asynchronous visits, same-day availability, and real-time availability for key plans.
- Oversee provider onboarding and offboarding, availability, OOO and emergency coverage, and day-to-day provider support.
- Identify and resolve bottlenecks affecting clinician productivity, patient access, and service delivery, referring clinical matters to the appropriate licensed professionals.
Payer Operations
- Set and execute our plan expansion strategy across Medicaid MCO, commercial, and Marketplace plans, deciding which plans we pursue and which we stop, so coverage keeps pace with Enterprise growth.
- Manage payer operations end to end, including applications and contracting, credentialing and provider enrollment, eligibility verification, claims workflows, and reimbursement.
- Oversee operational implementation of new plans and payer partnerships led by our CEO, including provider readiness, billing configuration, referral pathways, and data requests such as HEDIS reporting.
- Own revenue cycle performance, including rejections, denials, underpayments, and A/R, closing the gap between expected and actual payments in partnership with finance and any external billing partners.
- Maintain effective operational relationships with payer representatives and coordinate escalations involving coverage, enrollment, and claims processing.
Operational Leadership & Performance
- Establish and monitor KPIs across payer revenues, provider and payer operations, including consult success, provider capacity, access and turnaround times, coverage, claims performance, and operations cost per consult.
- Develop scalable processes, standard operating procedures, and internal controls that support growth across states, payers, and service lines.
- Lead and develop the Payer Operations, Provider Operations, and Revenue Cycle leads, setting clear performance expectations and a consistent operating rhythm.
- Provide leadership with clear reporting on operational performance, emerging risks, and improvement priorities.
- Scale operations cost-effectively, so cost does not grow in line with volume, by building and adopting automation and AI tools with clear PHI safeguards in partnership with product and engineering.
- Own practice infrastructure, including PC administration and ownership changes, collaborative practice agreements, state filings, and licensure and credential expirations, in partnership with legal and compliance.
Qualifications
We are looking for exceptional candidates who have:
- 7+ years of experience in healthcare operations, including leading payer and provider operations in a multi-state telehealth or virtual care company through a period of hypergrowth.
- 3+ years of experience leading operational teams, including guiding experienced leads and managers.
- Highly strategic and deeply analytical: you build the models yourself, understand unit economics, and turn data into decisions.
- Experience building capacity or staffing models for virtual clinicians, ideally including synchronous scheduling.
- A track record of scaling operations without proportional headcount, with the numbers to show for it.
- A track record of managing and growing revenues from clinical providers
- Effective at using AI tools in your daily work and a strong bias toward automating manual processes.
- Hands-on understanding of Medicaid MCO and commercial payer operations, including provider enrollment, credentialing, eligibility, claims processing, denials, and reimbursement.
- Working knowledge of healthcare regulatory and compliance requirements, including HIPAA, payer requirements, PC or MSO structures, and collaborative practice agreements.
- Strong communication and stakeholder management skills, including the ability to explain payer complexity to non-experts.
- Comfortable operating in a fast-paced, high-urgency environment, balancing strategy with going deep in the details when it matters.
- Bachelor's degree in healthcare administration, business, public health, or a related field.
- Bonus: women’s health or reproductive health experience, experience supporting value-based payer partnerships, and Spanish language skills.
Compensation & Total Rewards
- We offer a competitive total rewards package designed to recognize and reward meaningful contributions to the company's growth and success. The base salary range for this position is $130,000–$150,000 annually, complemented by performance-based cash bonus opportunities, equity participation, a comprehensive benefits package, and the flexibility to work remotely.
- Medical, dental, and vision insurance
- 12-week fully paid parental leave
- Fertility & family-forming financial assistance
- Generous PTO, paid holidays, sick time, and mental health days
- Access to 401k with matching
- Additional work-from-home support & perks
How to Apply
Please complete the application form and upload your resume here. Thank you for your interest and we look forward to reviewing your application!
