Payer Enrollment Specialist

About us

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.

About The Role:

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.

What You'll Do:

• Own the 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

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

Why you should join our team

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.

We strive to create an environment where employees from all backgrounds are respected. We also offer:

• 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)

At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.

Compensation

Our salary ranges are based on paying competitively for our company’s size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care. In accordance with New York City, Colorado, California, and other applicable laws, Pomelo Care is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. Given that this role is open to candidates of different skill levels, determining a salary range is challenging. A reasonable estimate of the current salary range is $55,000 to $65,000. We expect most candidates to fall in the middle of the range. We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash.

Potential Fraud Warning

Please be cautious of potential recruitment fraud. With the increase of remote work and digital hiring, phishing and job scams are on the rise with malicious actors impersonating real employees and sending fake job offers in an effort to collect personal or financial information.

Pomelo Care will never ask you to pay a fee or download software as part of the interview process with our company. Pomelo Care will also never ask for your personal banking or other financial information until after you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All official communication with Pomelo Care People Operations team will come from domain email addresses ending in @pomelocare.com.

If you receive a message that seems suspicious, we encourage you to pause communication and contact us directly at [email protected] to confirm its legitimacy. For your safety, we also recommend applying only through our official Careers page. If you believe you have been the victim of a scam or identity theft, please contact your local law enforcement agency or another trusted authority for guidance.