Director of Operations

28 million Americans with Medicaid need mental health care. Only a third of them will find it.

The math is devastating. Millions of America’s most vulnerable population are left waiting – not weeks, but months – without access to the mental health treatment they desperately need. Systemic barriers like operational complexity discourage practices from accepting Medicaid patients at all, and low reimbursement rates make them financially unattractive to most providers. This keeps care out of reach for those who need it most.

When Medicaid patients can’t find care, their treatable conditions escalate into crises. Emergency rooms become their only option. Lives that could have been transformed through early intervention instead spiral downward. This is a solvable problem.

This is where Third Space comes in.

We’re a virtual outpatient behavioral health practice built specifically for Medicaid patients. We’re on a mission to bridge this gap and rapidly increase access to care for underserved patients.

We accept most Medicaid and some commercial insurance plans. For patients, this means quality virtual therapy at no cost or very low cost – often as soon as 48 hours after reaching out.

We’ve proven there is enormous demand. Now we’re building the engine that allows us to serve that demand across states, payers, providers, and clinical services without sacrificing quality.

The numbers speak for themselves:

17 million lives covered across Medicaid and commercial plans

8x revenue growth in 2025

5 days median time to first appointment (vs. 3–6 months industry standard)

81% of Medicaid patients return for a second appointment

~60% of patients see measurable improvement in depression (PHQ-9) and anxiety (GAD-7) scores

We're not a stopgap. We're building what mental health care access in America should have always looked like.

Why work at Third Space

You'll move the needle on something that matters. Your work will directly touch millions of lives during, arguably, the most consequential moment for Medicaid in recent history.

You’ll solve problems that actually constrain access to care. Credentialing delays, payer complexity, broken workflows, and operational bottlenecks directly determine whether patients can get treated, and how soon they get into care after reaching out.

Strong PMF, scaling fast. Revenue grew 8x in 2025. We've proven the model and built the engine. Now we ned to make the operating system substantially more scalable.

Direct access and real ownership. You will work side-by-side with the founders and have genuine influence over how Third Space grows, while working with government and private stakeholders. You'll own P&L for some of the most important systems in the company.

You'll be building something that hasn’t existed before. Many of the processes you’ll ultimately manage still need to be designed, documented, automated, or rebuilt.

Humans + AI agents. Third Space is deploying AI agents across our operations. You won't just use AI tools; you'll help shape how an agentic care delivery company actually works in practice. You should be excited about figuring out what humans should own, what software should own, and how the two work together.

Backed by people who've done it before. Our investors include the former Chief Medical Officer of the US Medicaid program, founders of companies like Thirty Madison, Tennr, Jimini Health, Brellium, Altitude, Tilly Therapy, and investors in companies like Calm, Grow Therapy, BetterUp, Midi Health, and others.

Third Space is backed by Zeal Capital Partners, Actions Capital (fka K50 Ventures), RiverPark Ventures, Evio VC, and Pareto Holdings.

Join us at Third Space and help reimagine what’s possible for mental healthcare access in America – Come build America’s home page for Medicaid alongside us.

If you want to solve one of the most pressing challenges facing the country today, we want to hear from you.

About the Role

Almost every operational function at Third Space currently routes through our COO.

That worked when we were active in a handful of states. It won’t work when we triple our geographic footprint.

We’re hiring a Director of Operations to take ownership of the operational engine behind Third Space: credentialing and payer enrollment, revenue cycle, provider operations, new-state launches, compliance infrastructure, systems, vendors, and the team that keeps those functions moving.

This is not a role where you design the process and hand off the execution to someone else.

You’ll manage people, but you’ll also get into the details yourself. You should be comfortable opening a Medicaid portal to understand why an enrollment is stuck, digging through a denial report, figuring out why a workflow keeps failing, writing the SOP, and then redesigning the system so the problem doesn’t happen again.

We’re looking for someone who can move fluidly between:

Operating: solving the problem in front of you

Managing: creating accountability across a team and external partners

Building: turning repeated work into systems

Planning: seeing operational constraints before they become company constraints

You won’t be handed a finished playbook. You’ll help write it.

This is a hybrid position. Some travel may be required (~10%).

This role reports directly to the COO.

Read more about how we work: The Room We’re Building | Our Values

What You’ll Work On

Credentialing & Payer Operations

Own the operational lifecycle required to get clinicians credentialed, enrolled, and ready to serve patients.

You’ll manage the credentialing function, establish clear turnaround targets, maintain a reliable view of every application and payer, and personally unblock difficult cases when needed.

You’ll continuously improve the systems behind CAQH, PECOS, state Medicaid enrollment, MCO enrollment, roster management, revalidations, and payer administration.

The goal isn’t just to process applications. It’s to make credentialing predictable enough that the rest of the company can plan around it.

New-State Launches

Own the operational playbook for launching Third Space into new markets.

You’ll coordinate payer enrollment and contracting, regulatory and operational requirements, provider readiness, billing configuration, systems setup, and launch dependencies across teams.

Every state we launch should make the next one faster.

You’ll turn what we learn into a documented, repeatable operating system.

Provider Operations

Own the operational systems that support our clinical workforce from onboarding through ongoing operations.

That includes onboarding and offboarding workflows, compensation and payment operations, HRIS administration, operational issue resolution, provider data integrity, and coordination across credentialing, billing, recruiting, and clinical leadership.

You’ll also help build the capacity model that connects patient demand with provider supply and gives recruiting a clear view of where we need additional clinical capacity.

Revenue Cycle

Own the operating relationship between Third Space, our billing partners, our payers, and our internal systems.

You should be able to look at an aging report or denial trend and understand where money is getting stuck.

You’ll hold partners to defined service levels, ensure billing configuration stays accurate, identify recurring failure modes, and drive improvements across clean claims, denials, collections, and A/R.

You don’t need to personally submit every claim. You do need to understand the system well enough to know when it isn’t working.

Compliance & Operational Readiness

Build the operational infrastructure that keeps a multi-state healthcare company audit-ready.

Own recurring compliance workflows including credential maintenance, exclusion screening, revalidations, attestations, provider records, and other operational requirements.

Partner with clinical leadership wh