Payer Enrollment Specialist

Pomelo Care • New York, NY

5h • Remote

About The Position

At Pomelo Care, we are redefining the healthcare journey for women and children. As the leading virtual medical practice in our field, we provide a continuous circle of support—from the first steps of family building and the complexities of pregnancy to the nuances of postpartum, pediatric, and midlife care. We aren't just a clinic; we are a multidisciplinary engine of clinicians, engineers, and problem-solvers dedicated to closing the gaps in traditional care. By leveraging a high-touch, technology-driven platform, we identify risks early and deliver deeply personalized, 24/7 virtual care. We are here to prove that better data and patient-centered care lead to better outcomes, raising the standard of care 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.

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

Responsibilities

• Own 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

Benefits

• 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)

What This Job Offers

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