Pomelo Care Logo

Pomelo Care

Payer Enrollment Specialist

Posted 5 Days Ago
Be an Early Applicant
Remote
Hiring Remotely in United States
55K-65K Annually
Mid level
Remote
Hiring Remotely in United States
55K-65K Annually
Mid level
Manage end-to-end payer enrollment and re-enrollment for clinicians across existing and new markets. Support licensing, credentialing, Medicaid enrollment, and renewals while coordinating with clinicians, vendors, and internal teams. Improve operational processes to reduce onboarding time and help providers begin seeing patients sooner. The role requires healthcare operations experience, payer credentialing expertise, strong prioritization, attention to detail, and cross-functional collaboration.
The summary above was generated by AI

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: Manage payer enrollments, and payer re-enrollments across clinician types for our existing and new markets. Reporting to the Payer Enrollments Manager, in this role, you will have the following responsibilities:

What You’ll Do
  • Own the the end-to-end process for enrolling new providers with 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 with payers 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

Who You Are
  • 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

Compensation

The expected base salary range offered for this role is $55,000-$65,000. 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.

Similar Jobs

48 Minutes Ago
Remote
United States
126K-153K Annually
Senior level
126K-153K Annually
Senior level
Artificial Intelligence • HR Tech • Information Technology • Software • Business Intelligence
Advises health plans and provider networks on member and patient experience improvement. Leads payer-provider collaboration, performance improvement initiatives, training, coaching, metric interpretation, and end-to-end client engagements. Uses PDSA and healthcare quality frameworks to improve CAHPS, HEDIS, HOS, Star Ratings, and value-based care outcomes. Requires healthcare operations expertise, provider-setting experience, strong presentation skills, and nationwide travel.
Top Skills: ExcelMS OfficePowerPointWord
An Hour Ago
Remote or Hybrid
50K-93K Annually
Mid level
50K-93K Annually
Mid level
Automotive • Professional Services • Software • Consulting • Energy • Chemical • Renewable Energy
Manages and grows a portfolio of specialty TIC accounts across the Northeastern United States. Promotes and sells hazardous locations, oil and gas, EMC, wireless, and other technical testing, inspection, and certification services primarily through remote communication. Builds customer relationships, identifies opportunities, articulates technical value propositions, supports account owners throughout the sales cycle, coordinates technical resources, and works toward sales targets. Travel may be required for high-potential customer outreach.
Top Skills: Crm SoftwareEmcExcelMicrosoft OutlookMicrosoft PowerpointMicrosoft WordWireless
2 Hours Ago
Remote or Hybrid
45K-85K Annually
Junior
45K-85K Annually
Junior
Artificial Intelligence • Fintech • Insurance • Marketing Tech • Software • Analytics
Handle inbound calls and warm leads, consult customers on insurance needs, recommend appropriate Property and Casualty products and coverage, and convert prospects into policyholders. Representatives receive paid training and licensing support, work remotely on scheduled weekday and weekend shifts, and use sales, communication, persuasion, analytical, and organizational skills to achieve results.
Top Skills: PcWired High-Speed Internet

What you need to know about the Chicago Tech Scene

With vibrant neighborhoods, great food and more affordable housing than either coast, Chicago might be the most liveable major tech hub. It is the birthplace of modern commodities and futures trading, a national hub for logistics and commerce, and home to the American Medical Association and the American Bar Association. This diverse blend of industry influences has helped Chicago emerge as a major player in verticals like fintech, biotechnology, legal tech, e-commerce and logistics technology. It’s also a major hiring center for tech companies on both coasts.

Key Facts About Chicago Tech

  • Number of Tech Workers: 245,800; 5.2% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: McDonald’s, John Deere, Boeing, Morningstar
  • Key Industries: Artificial intelligence, biotechnology, fintech, software, logistics technology
  • Funding Landscape: $2.5 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Pritzker Group Venture Capital, Arch Venture Partners, MATH Venture Partners, Jump Capital, Hyde Park Venture Partners
  • Research Centers and Universities: Northwestern University, University of Chicago, University of Illinois Urbana-Champaign, Illinois Institute of Technology, Argonne National Laboratory, Fermi National Accelerator Laboratory

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account