Credentialing & Enrollment Lead

Mira Mace • New York, NY

3d

About The Position

We're looking for a Credentialing & Enrollment Lead who can own our multi-state provider enrollment strategy end-to-end. You'll be the person who tells us what to do — not the other way around.
We're a telehealth-first Medicare navigation company operating through a PC-MSO structure across multiple states. We've built the product and the clinical team. Now we need someone who deeply understands the credentialing and payer enrollment landscape to unblock our ability to serve Medicare Advantage and Medicaid patients at scale.
You'll work directly with the founders and report to the COO. This isn't a "process applications and wait" role — it's a strategic hire where you'll shape how we approach payer relationships, contracting, and multi-state enrollment.
We're a small, focused team, and this role will have a direct impact on our payer strategy, enrollment operations, and ability to scale to new states. You'll collaborate closely with leadership and our clinical team to build the credentialing infrastructure that lets us actually serve patients.

Requirements

• You've done multi-state telehealth credentialing before — not just in-person, single-location enrollment.
• You understand PC-MSO structures and how they affect payer enrollment.
• You've worked with Medicare Advantage payers and state Medicaid programs directly.
• You know CAQH, PECOS, and at least a few state Medicaid portals inside and out.
• You've dealt with payer contracting — you know what happens after credentialing.
• You can operate independently — we need someone who brings the answers, not just the questions.
• You're comfortable in a small, fast-moving team where you'll have real ownership and direct access to leadership.

Nice To Haves

• experience with delegated credentialing
• MAC jurisdictions
• EDI enrollment

Responsibilities

• Own provider enrollment end-to-end. MA, Medicaid, and Original Medicare across multiple states — applications, follow-ups, and issue resolution.
• Lead credentialing strategy. CAQH, PECOS, state Medicaid portals — you know what needs to happen and in what order.
• Navigate payer contracting. Understand fee schedules, contracting timelines, and what's negotiable.
• Build the playbook. Document processes so enrollment doesn't live in anyone's head.
• Troubleshoot and escalate. When applications stall, get denied, or get filed incorrectly — you know how to fix it.
• Advise on structure. Understand how PC-MSO structures, telehealth, and multi-state licensure interact with enrollment.

Benefits

• Mission with meaning. We're building something that makes healthcare a little less painful for real people. When we get it right, we help someone when they need it most avoid thousands in unnecessary medical costs — or get care they might otherwise miss.
• High ownership. You'll define how we approach payer enrollment from the ground up.
• Real impact. Every enrollment you unblock directly translates to patients we can serve.
• Grow with us. Build and lead the credentialing function as the company scales.
• Meaningful early equity. Real ownership in what we're building.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed