Associate Director – Payer and Clinical Operations

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $133.6k - $178.1k / year

⏰ Full Time

🟠 Senior

🏥 Clinical Operations

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Babylist

WebsiteLinkedInAll Job Openings

51 - 200 employees

🛍️ eCommerce

🛒 Retail

💰 $40M Series C on 2021-11

eCommerce • Retail

Babylist is the leading vertical marketplace and commerce destination for baby products, driving purchase decisions for more than 8 million people each year. It utilizes robust proprietary data, patented technology, and unbiased editorial guidance to recommend expert-tested products to those starting their parenting journey. Babylist registries connect new parents with their community of family and friends who help plan, prepare, and shop for a child's arrival. Founded in 2011 by Natalie Gordon, Babylist has grown from a side project into a generational brand in the $67 billion baby products market.

📋 Description

• Own onboarding of every new payer, including process, timelines, and cross-functional collaboration • Keep existing payer operations running cleanly and resolve operational friction • Ensure efficient payer AR processes, EFT setup, payment schedules, eligible sub-plan servicing, and updates to allowable amounts in systems • Own licensing and credentialing for clinical services, including IBCLC credentialing • Lead responses to audits, site inspections, and license renewals • Identify and implement compliance best practices across Babylist Health • Manage payer transitions end-to-end • Build and maintain visibility into payer-level performance • Program-manage daily business reporting and monitoring • Program-manage the operational side of new launches, including new DME types and lines of business • Manage and develop two direct reports • Partner cross-functionally with billing/RCM, legal, product, and payer contracting teams

🎯 Requirements

• Experience running payer operations at scale across more than one contract type or service line • Strong knowledge of healthcare licensing and credentialing, including state licensure, site inspections, payer-level credentialing, and IBCLC credentialing • Experience owning operational relationships with payers directly • Experience in multi-state regulatory compliance • Experience managing both commercial and Medicaid payer work, including Medicaid expansion into new states • Ability to set direction and write requirements • Strong people management, coaching, and performance management skills • Ability to build processes for ambiguous, fast-changing operational work • Experience operating across a large, matrixed organization • Experience partnering with billing/RCM, legal, product, customer support, and payer contracting teams • Comfortable using AI tools in daily work

🏖️ Benefits

• Competitive pay and meaningful opportunities for career advancement • Career progression and performance-based advancement • Company-paid medical, dental, and vision insurance • Retirement savings plan with company matching • Flexible spending accounts • Generous paid parental leave and PTO • Winter Wonder Week: the whole company takes a paid week off at the end of the year • Remote work stipend to set up your office • Perks for physical, mental, and emotional health, parenting, childcare, and financial planning • Leading tools like Claude and ChatGPT from day one

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