
Manager, Payer Enrollments
What you need
- 3+ yrs enrolling providers with payers
- 2+ yrs people management experience
- 2+ yrs healthcare operations experience
- 1+ yrs managing licensing and credentialing
- Exceptional project management and prioritization skills
What you'll do
- Manage licensing and credentialing specialists team
- Own payer enrollment strategy across specialties and states
- Identify enrollment coverage gaps using data
- Manage third-party licensing vendor and SLAs
- Lead audits for licensing, credentialing, and enrollment
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.
About the Role
Your North Star: Substantially contribute to the strategy of, and own the execution of, our payer enrollments across new and existing markets within our midlife (perimenopause and menopause) program. Own the execution of licensing for midlife providers.
Reporting to the Director, Operations and Clinical Quality, you will have the following responsibilities:
What You’ll Do
Manage a team of licensing and credentialing specialists. Oversee the end-to-end process for licensing, credentialing and enrolling providers with states and our health plan partners within our midlife offering.
In partnership with the Director, Operations and Clinical Quality, own the enrollment strategy across clinical specialties, payers and geographic states to ensure adequate coverage and access to care for midlife patients
Leverage data to proactively identify gaps in both process and clinician enrollment coverage
Proactively identify and implement process improvements, both internally and with third parties
Work cross-functionally with our customer success, market operations, and clinical teams to hit our enrollment goals
Manage relationship with third-party licensing vendor, including holding them accountable to SLAs
Lead audit activities related to midlife licensing, credentialing, and enrollment including delegated credentialing agreements
Who You Are
3+ years experience enrolling APPs, therapists, registered dietitians, physicians, and/or doulas with payers
2+ 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
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 women’s health
Compensation
The expected base salary range offered for this role is $95,000-$115,000. This role is also eligible for equity, giving you an ownership stake in Pomelo’s mission. Actual compensation may vary based on relevant experience, skills, competencies, and certifications.
Benefits and Perks
By joining Pomelo, you’ll get in on the ground floor of a fast-moving, well-funded startup on a mission to improve outcomes for all mothers and babies. We cultivate a collaborative, patient-first environment where data drives our decisions and team members are challenged to learn, grow, and have fun together. We also offer:
Comprehensive Health, Dental, and Vision coverage for employees and their families
High deductible Health Plans with Health Savings Account (HSA) options
Flexible Spending Account (FSA)
Equity grant participation
401(k) program
Competitive vacation policy
16 weeks paid parental leave
Fully remote work flexibility (within the US) with offices in NYC and SF for those who prefer in-person work
We are committed to hiring the best team to improve outcomes for all mothers and babies. To solve the complex challenges facing the diverse population we serve, we need diverse perspectives, actively welcoming people of all races, ages, sexual orientations, gender identities and expressions, national origins, religions, disabilities, and veteran statuses. We strive to cultivate an inclusive and respectful environment where team members thrive by working across disciplines, moving fast, making data driven decisions, learning continuously, and always putting the patient first.
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About Pomelo Care
Pomelo Care is building the first at-scale, evidence-based pregnancy and newborn care platform, transforming outcomes for pregnant people and babies.
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