Senior Manager, Licensing, Credentialing, & Enrollments Jobs

Pomelo Care

145000.00 - 170000.00 USD / Year

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Own the strategy and execution of our licensing, credentialing, and Medicaid enrollments across new and existing markets.

Manage a team of licensing and credentialing associates and managers
Oversee the end-to-end process for licensing, credentialing and enrolling providers with states and our health plan partners
Own and implement licensing, credentialing, and enrollment strategy across clinical specialties, payers and geographic states to ensure adequate coverage and access to care for patients
Leverage data to proactively identify gaps in both process and clinician licensing, credentialing, and enrollment coverage
Proactively identify and resolve process improvements, both internally and with third parties
Own processes related to the Pomelo Credentialing Committee
Work cross-functionally with our customer success, market operations, and clinical teams to hit our licensing and credentialing goals
Manage relationship with third-party licensing vendor, including holding them accountable to SLAs
Lead audit activities related to licensing, credentialing, and enrollment including delegated credentialing agreements
Scale the licensing, credentialing, and payer enrollment guide across all Pomelo states and payers

5+ years healthcare operations experience, ideally having worked within healthcare delivery or a high-growth startup
2+ years people management experience
1+ years experience managing licensing, credentialing, and enrollment activities
Experience with credentialing APPs, therapists, registered dietitians, physicians, and doulas with Medicaid managed care plans preferred
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
Exceptional ability to work cross-functionally with clinicians, technical teams, and external vendors / contacts
Passionate about maternal and child health

What we offer:

Competitive healthcare benefits
Generous equity compensation
Unlimited vacation
Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)

Employment Type:

Fulltime

Work Type:

Remote work

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