Payer Enrollment Specialist

As a Payer Enrollment Specialist at Pomelo Care, you will be responsible for managing 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.

Key responsibilities include:

• Owning 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
• Working closely with new clinical hires and our third-party vendor to manage new license applications and license renewals
• Partnering with the Licensing, Credentialing, and Enrollment team to enroll providers in Medicaid across existing and new markets
• Identifying opportunities to improve our licensing, payer credentialing, and enrollment processes to shorten the time for clinicians to start seeing patients

To succeed in this role, you will need:

• 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

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.