Director of Health Plan Operations

Join Cartwheel to help tackle the student mental health crisis. 

Cartwheel is an early-stage company building a new kind of mental health program for kids that puts schools at the center. We see our role as supporting school staff who see kids every single day. Instead of going around them, we collaborate with them. This means: 

• Earlier intervention
• Higher student and family engagement in care
• Better coordination among the trusted adults in a student’s life 

Kids shouldn't just aspire to get out of bed and drag themselves to class. They should be able to experience joy. They deserve to envision and build a life they’re excited to live. If you join Cartwheel, you’ll help make this vision a reality for millions of students across the country. We’re backed by top investors including Menlo Ventures, Reach Capital, General Catalyst, BoxGroup, and Able Partners, and we're looking for mission-driven teammates to join our team.

ABOUT THE ROLE

Cartwheel is a successful and growing telehealth platform revolutionizing access to mental health care for schools, students, and families. We work with nearly 200 school districts to provide life-saving mental health services to a diverse population (50-50 Medicaid/Commercial mix). 

We’re scaling quickly – from about 1,500 therapy sessions per week across 9 states today to more than double the number of sessions across 20 states in the next year. 

As Cartwheel’s Director of Health Plan Operations, you will drive Cartwheel’s payer strategy and compliance, oversee a team responsible for payer enrollment, credentialing and licensing, and work alongside our Senior Manager of Revenue Cycle to establish a high-performing health plan operations function that is set up for scale.

Role type: This is a W2, Full-Time, Salaried position

Location: US Remote 

Start date: Spring 2025

Reports to: VP of Operations, Victoria Cody

WHAT YOU’LL DO

In your first 30 days, you’ll:

• Learn the ins and outs of Cartwheel’s processes, and start identifying process improvements in health plan operations
• Become proficient in the systems we use, including Apero, Healthie, the Cartwheel portal, Guru, Asana, Slack and Google Suite
• Start managing Cartwheel’s payer partnerships and processes
• Get to know the team! 

Ongoing, you will: 

• Manage all payer relationships and contracting, including upfront contracting, ongoing contract negotiation, and appropriate escalation and resolution of issues
• Establish and oversee processes to ensure compliance with legal and regulatory requirements and build a culture of compliance in partnership with operations and clinical leadership
• Ensure Cartwheel is an in-network provider with all state Medicaid, MCO, and commercial payers in the states in which we operate and the states to which we plan to expand
• Oversee a team responsible for payer enrollment, provider credentialing, and provider licensing, ensuring strong performance
• Maintain accurate records of Cartwheel’s network status with payers and individual clinicians’ credentialing status
• Partner effectively with RCM team to achieve key performance metrics including reimbursement rates and collections rate
• Collaborate with teams across Cartwheel including Business Operations, Care Operations, Clinical Operations, People & Culture, and Technology
• Continually evaluate health plan operations processes and implement improvements for efficient scale as Cartwheel grows

WHO YOU ARE 

• Embodies our values: Human, Humble, Accountable, Innovative, Resilient
• Has 7-10+ years of health plan operations experience, including group contracting, payer enrollment and provider credentialing, and compliance
• Strong preference for experience with virtual / telehealth mental and behavioral health services 
• Thrives in a world of rapid startup growth
• Achieves quality results quickly and prioritizes outcomes
• Uses data to drive decisions, and has a keen understanding of dashboards and metrics
• In the face of competing priorities, prioritizes and moves forward without getting stuck
• Seamlessly transitions between strategic thinking and hands-on operations
• Most importantly, you're ready to support our mission and drive core health plan operations functions that will help tens of thousands of students and families nationwide get the mental health care they need.

WHY YOU’LL LOVE CARTWHEEL

Our hope is that Cartwheel will be your best career decision! In addition to tackling one of the biggest challenges of our time, a