[Hiring] Manager, Payer Enrollments @Pomelo Care

Role Description

Your North Star:

Substantially contribute to the strategy of, and own the execution of, our payer enrollments across new and existing markets within our midlife (perimenopause and menopause) program. Own the execution of licensing for midlife providers.

Reporting to the Director, Operations and Clinical Quality, you will have the following responsibilities:

What You’ll Do

• Manage a team of licensing and credentialing specialists.
• Oversee the end-to-end process for licensing, credentialing and enrolling providers with states and our health plan partners within our midlife offering.
• In partnership with the Director, Operations and Clinical Quality, own the enrollment strategy across clinical specialties, payers and geographic states to ensure adequate coverage and access to care for midlife patients.
• Leverage data to proactively identify gaps in both process and clinician enrollment coverage.
• Proactively identify and implement process improvements, both internally and with third parties.
• Work cross-functionally with our customer success, market operations, and clinical teams to hit our enrollment goals.
• Manage relationship with third-party licensing vendor, including holding them accountable to SLAs.
• Lead audit activities related to midlife licensing, credentialing, and enrollment including delegated credentialing agreements.

Qualifications

• 3+ years experience enrolling APPs, therapists, registered dietitians, physicians, and/or doulas with payers.
• 2+ 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.
• Exceptional project management and prioritization skills.
• 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 women’s health.

Requirements

• The expected base salary range offered for this role is $95,000-$115,000.
• 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

• 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.