Payer Enrollment Specialist
External
Pomelocare · USPrepare for this interview
EliteAI-generated questions, company research, and talking points tailored to this role
About the role
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. Your north star: Manage licensing activities, Medicaid enrollments, payer credentialing, and payer re-credentialing across clinician types for our existing and new markets. This role reports to the Director, Operations & Clinical Quality and can be based anywhere in the continental US.
Responsibilities
- Own the the end-to-end process for enrolling new providers with state Medicaid and 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 in Medicaid 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
Requirements
- 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
- Why you should join our team
- By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup that always puts the patient first. You will learn, grow and be challenged, and have fun with your team while doing it.
- We strive to create an environment where employees from all backgrounds are respected. We also 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)
Benefits
Your Match
How well this role fits your profile.
Company Intel
What employees say
Worked at pomelocare? Share your experience