Payer Operations Lead

Responsibilities

• Build, document, and maintain end-to-end SOPs for payer contracting, enrollment, and credentialing workflows.
• Design quality controls and error-catching checkpoints to reduce rework and rejected applications.
• Identify bottlenecks in the expansion pipeline and drive cycle-time improvements.
• Keep enrollment and contracting trackers up to date, flag aging items and delays, and escalate blockers with proposed solutions.
• Conduct persistent, proactive follow-up with payers via phone, email, and payer portals to confirm receipt, resolve deficiencies, and push applications to approval.
• Prepare, submit, and track payer contract applications for new health plan partnerships and new service lines.
• Serve as a quality and productivity coach for offshore enrollment team members: set standards, review work, give feedback, and build playbooks.
• Assist Sr. Manager with onboarding and ramping offshore contributors on payer processes and tools.
• Partner with RCM and payer strategy/business development teams on collaborative problem-solving or strategic payer initiatives.

Requirements

• 2-3 years of experience in provider enrollment, credentialing, payer contracting, or healthcare administration (internship or adjacent revenue cycle experience considered).
• Demonstrated experience building or documenting processes and SOPs.
• Experience coaching, training, or quality-reviewing others' work (formal management not required).
• Comfort owning metrics and reporting on pipeline throughput.
• Highly independent and driven; relentless follow-up (including calling and escalating within payer networks), manage own queue without reminders.
• Exceptional attention to detail and organizational skills.

Nice-to-Haves

• Hands-on experience with payer portals and third party portals i.e. Availity.
• Familiarity with commercial payer requirements (Understanding Medicare and Medicaid processes is a plus).
• Experience in multi-state telehealth, digital health, or a high-growth healthcare environment.
• Exposure to credentialing standards (e.g., NCQA, CMS).

Compensation & Benefits

• $60,000-$68,000 base salary with opportunities for advancement.
• Equity.
• Professional development & employee learning programs.
• 100% remote within the U.S.
• Unlimited PTO & 11 company holidays.
• Medical, dental, and vision benefits; HSA & FSA.
• Long- and short-term disability coverage.
• Annual employee wellness stipend.
• 401(k) plan.
• Parental leave & family planning support benefits.
• Company-issued laptop.
• Annual work-from-home stipend.
• Commuter benefits (if applicable).