Payer Operations Lead

Opportunity

We're seeking an enthusiastic and process-driven Payer Operations Lead to own the most complex and high-stakes payer enrollments, build the documented processes our function runs on, and serve as the quality and coaching anchor for our enrollment team.

Your Impact

• Build, document, and maintain end-to-end SOPs for payer contracting, enrollment, and credentialing workflows — turning tribal knowledge into repeatable, auditable process
• Design quality controls and error-catching checkpoints that reduce rework and rejected applications
• Identify bottlenecks in the expansion pipeline and drive cycle-time improvements
• Keep enrollment and contracting trackers meticulously 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 application receipt, resolve deficiencies, and push applications through to approval. Own each item until it's done
• Prepare, submit, and track payer contract applications for new health plan partnerships and new service lines, ensuring submissions are complete, accurate, and on time
• Serve as a quality and productivity coach for offshore enrollment team members: set standards, review work, give feedback, and build the playbooks they execute against
• Assist Sr. Manager with onboarding and ramping offshore contributors on payer processes and tools
• Partner with RCM and payer strategy/business development teams in collaborative problem-solving or strategic payer initiatives

Required Qualifications

• 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. You follow up relentlessly (including comfort calling and escalating within payer networks), manage your own queue without reminders, and don't let applications sit
• Exceptional attention to detail and organizational skills; you take pride in accurate, deadline-driven work

Preferred Qualifications

• 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)