Enrollment & Credentialing Lead — Medicare & Medicaid

MiraMace, Inc.; United States; A distancia; USD 120.000 - 180.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Equity

Impact on patient care

Descripción de la vacante

Mira Mace, Inc. is building an AI-powered healthcare assistant to simplify navigating the healthcare system.

We are seeking a provider enrollment lead to own end-to-end enrollment for Medicare Advantage, Medicaid, and Original Medicare across multiple states, guiding credentialing strategy with CAQH, PECOS, and state portals. The role requires deep familiarity with PC-MSO structures, payer enrollment impacts, and experience with Medicare Advantage payers and state Medicaid programs.

Formación

• Experience with multi-state telehealth credentialing.
• Understanding of PC-MSO structures and their effect on payer enrollment.
• Direct experience with Medicare Advantage payers and state Medicaid programs.
• Proficiency with CAQH, PECOS, and state Medicaid portals.
• Experience with payer contracting processes.
• Ability to operate independently in a fast-moving startup environment.

Responsabilidades

• Own provider enrollment end-to-end for Medicare Advantage, Medicaid, and Original Medicare across multiple states.
• Lead credentialing strategy using CAQH, PECOS, and state Medicaid portals.
• Navigate payer contracting, including fee schedules and contracting timelines.
• Build and document the enrollment playbook and processes.
• Troubleshoot and resolve stalled or denied applications.
• Advise on how PC-MSO structures and telehealth interact with enrollment.

Conocimientos

Credentialing leadership

CAQH/PECOS

Medicare/Medicaid enrollment

Payer contracting

Telehealth credentialing

Independent work

Herramientas

CAQH

PECOS

Descripción del empleo

Mira Mace, Inc. is building an AI-powered healthcare assistant to simplify navigating the healthcare system.

We are seeking a provider enrollment lead to own end-to-end enrollment for Medicare Advantage, Medicaid, and Original Medicare across multiple states, guiding credentialing strategy with CAQH, PECOS, and state portals. The role requires deep familiarity with PC-MSO structures, payer enrollment impacts, and experience with Medicare Advantage payers and state Medicaid programs.