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Pomelo Care · 1 month ago

Senior Manager, Licensing, Credentialing, & Enrollments

United States

Full-time

Remote

Senior Level

$145K/yr - $170K/yr

5+ years exp

Pomelo Care is a multi-disciplinary team focused on improving care for moms and babies through a technology-driven platform. The Senior Manager of Licensing, Credentialing, and Enrollments will own the strategy and execution of licensing and credentialing processes while managing a team to ensure adequate coverage and access to care.

ChildrenHealth CareMobile AppsWomen's

Responsibilities

Manage a team of licensing and credentialing associates and managers

Oversee the end-to-end process for licensing, credentialing and enrolling providers with states and our health plan partners

Own and implement licensing, credentialing, and enrollment strategy across clinical specialties, payers and geographic states to ensure adequate coverage and access to care for patients

Leverage data to proactively identify gaps in both process and clinician licensing, credentialing, and enrollment coverage

Proactively identify and resolve process improvements, both internally and with third parties

Own processes related to the Pomelo Credentialing Committee

Work cross-functionally with our customer success, market operations, and clinical teams to hit our licensing and credentialing goals

Manage relationship with third-party licensing vendor, including holding them accountable to SLAs

Lead audit activities related to licensing, credentialing, and enrollment including delegated credentialing agreements

Scale the licensing, credentialing, and payer enrollment guide across all Pomelo states and payers

Qualification

Healthcare operationsLicensing managementCredentialing experiencePeople managementOperational process scalingProject managementComfort with ambiguityPassion for maternal healthAttention to detailCross-functional collaborationResults-oriented

Required

5+ 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

Experience building and scaling operational processes for clinicians

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 maternal and child health

Preferred

Experience with credentialing APPs, therapists, registered dietitians, physicians, and doulas with Medicaid managed care plans

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)