Payer Enrollment Specialist

Pomelo Care; United States; Remoto; USD 55.000 - 65.000; Tempo pieno

Vantaggi offerti da questo lavoro

Equity grant participation

401(k) program

Competitive vacation policy

16 weeks paid parental leave

Fully remote work within the US (NYC/S

Descrizione del lavoro

Pomelo Care is seeking a Payer Enrollments professional to manage provider enrollments and re-enrollments across clinician types for existing and new markets in a fully remote role within the United States.

You will work with the Payer Enrollments Manager and cross-functional teams to license, credential, and enroll clinicians with payers, including Medicaid managed care plans, and identify opportunities to streamline processes so clinicians can start seeing patients sooner.

Competenze

• 3+ years in healthcare operations or similar roles.
• Experience with payer credentialing for various clinician types.
• Experience enrolling clinicians in Medicaid/state programs.
• Strong project management and prioritization skills.
• Ability to build and scale operational processes for clinicians.

Mansioni

• Own the end-to-end process for enrolling new providers with health plan partners.
• Collaborate with new clinical hires and vendors to manage license applications and renewals.
• Partner with Licensing, Credentialing, and Enrollment team to enroll providers with payers.
• Identify opportunities to improve licensing, payer credentialing, and enrollment processes to shorten start times for clinicians.

Conoscenze

Healthcare operations

Project management

Attention to detail

Cross-functional collaboration

Ability to work with ambiguity

Payer credentialing experience

Descrizione del lavoro

Pomelo Care is the leading virtual medical practice for women and children, providing care across pregnancy, postpartum, pediatrics, menopause, and perimenopause. We combine proactive, 24/7 clinical care with technology that helps us reach patients earlier, identify risks sooner, and deliver personalized care throughout their journey. Our team includes clinicians, technologists, operators, and problem-solvers working together to make high-quality care more accessible for families nationwide.

About the Role

Your North Star: Manage payer enrollments, and payer re-enrollments across clinician types for our existing and new markets. Reporting to the Payer Enrollments Manager, in this role, you will have the following responsibilities:

What You’ll Do

• Own the the end-to-end process for enrolling new providers with our health plan partners, supporting newly hired clinicians on all requirements for licensing, credentialing, and enrollment

• Work closely with new clinical hires and our third-party vendor to manage new license applications and license renewals

• Partner with the Licensing, Credentialing, and Enrollment team to enroll providers with payers across existing and new markets

• Identify opportunities to improve our licensing, payer credentialing, and enrollment processes to shorten the time for clinicians to start seeing patients

Who You Are

• 3+ years healthcare operations experience, ideally having worked within healthcare delivery or a high-growth startup

• Experience with payer credentialing for roles including APPs, therapists, registered dietitians, physicians, and doulas with Medicaid managed care plans

• Experience enrolling clinicians in state medicaid

• Exceptional project management and prioritization skills

• Experience building and scaling operational processes for clinicians

• Results-oriented operator who moves fast

• Meticulous attention to detail

• Comfort with ambiguity

• Ability to work cross-functionally with clinicians and technical teams

• Passionate about maternal and child health

Compensation

The expected base salary range offered for this role is $55,000-$65,000. This role is also eligible for equity, giving you an ownership stake in Pomelo’s mission. Actual compensation may vary based on relevant experience, skills, competencies, and certifications.

Benefits and Perks

By joining Pomelo, you’ll get in on the ground floor of a fast-moving, well-funded startup on a mission to improve outcomes for all mothers and babies. We cultivate a collaborative, patient-first environment where data drives our decisions and team members are challenged to learn, grow, and have fun together. We also offer:

• Comprehensive Health, Dental, and Vision coverage for employees and their families

• High deductible Health Plans with Health Savings Account (HSA) options

• Flexible Spending Account (FSA)

• Equity grant participation

• 401(k) program

• Competitive vacation policy

• 16 weeks paid parental leave

• Fully remote work flexibility (within the US) with offices in NYC and SF for those who prefer in-person work

We are committed to hiring the best team to improve outcomes for all mothers and babies. To solve the complex challenges facing the diverse population we serve, we need diverse perspectives, actively welcoming people of all races, ages, sexual orientations, gender identities and expressions, national origins, religions, disabilities, and veteran statuses. We strive to cultivate an inclusive and respectful environment where team members thrive by working across disciplines, moving fast, making data driven decisions, learning continuously, and always putting the patient first.