Senior Manager, Licensing, Credentialing, & Enrollments

Senior Manager, Licensing, Credentialing, & Enrollments

Pomelo Care is a multi-disciplinary team of clinicians, engineers, and problem solvers who are passionate about improving care for moms and babies. We are transforming outcomes for pregnant people and babies with evidence-based pregnancy and newborn care at scale. Our technology-driven care platform enables us to engage patients early, conduct individualized risk assessments for poor pregnancy outcomes, and deliver coordinated, personalized virtual care throughout pregnancy, NICU stays, and the first postpartum year. We measure ourselves by reductions in preterm births, NICU admissions, c-sections, and maternal mortality; we improve outcomes and reduce healthcare spend.

Role Description

Your North Star : Own the strategy and execution of our licensing, credentialing, and Medicaid enrollments across new and existing markets.

Reporting to the Senior Manager, Operations and Clinical Quality, you will have the following responsibilities :

What You'll Do

• 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

Who You Are

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 where you will have a profound impact on the patients we serve. And you'll learn, grow, 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 value working across disciplines, moving fast, data-driven decision making, learning, and always putting the patient first. We also offer :

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.

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. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. A reasonable estimate of the current salary range is $145,000 to $170,000. 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.

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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 careers@pomelocare.com 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.