Senior Manager – Payer Enrollment Operations

Job not on LinkedIn

🔥 24 minutes ago

🇺🇸 United States – Remote

💵 $175k - $215k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

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Medallion

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2020

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

💰 $43M Series C - Medallion on 2025-08

Healthcare • Healthcare Insurance • SaaS

Medallion is an AI-powered healthcare operations company that provides a SaaS platform to automate provider credentialing, payer enrollment, licensing, privileging, and ongoing monitoring. The platform uses machine learning and real-time automation to extract and standardize data, manage payer-specific and state rules, run automated follow-ups, and ensure compliance with NCQA and TJC standards—reducing costs and accelerating provider onboarding. Medallion serves payers, provider groups, health systems, RCM organizations, and digital health companies with a focus on lowering administrative burden and improving network readiness.

📋 Description

• Lead the operational side of implementation through go-live, standing up the team, workflows, reporting and client cadence • Build instrumentation to track files, blockers and commitments • Develop working knowledge of payer-specific requirements, revalidation and follow-up • Own end-to-end delivery against contractual SLAs and SLOs • Serve as operational point of contact for client stakeholders and own client health and satisfaction • Run performance reviews, escalations and weekly/monthly reporting • Lead an on/offshore team of team leads, enrollment specialists and quality analysts, including the team in India and potentially a BPO partner • Manage escalated enrollments and partner with payer relationships to resolve delays, rejections and discrepancies • Build capacity plans, shift coverage, performance reviews, coaching and performance management • Partner with Product and Engineering to automate manual work and reduce rework • Own account economics, productivity, automation rate and cost to serve • Create playbooks for future enterprise launches • Take on additional enterprise clients once the account is stable • Report to the GM of Payer Enrollment / VP of Business Operations

🎯 Requirements

• 5+ years in strategy & operations, BizOps, management consulting, program management or operations leadership, ideally in a high-growth company • Track record of owning outcomes end to end, with measurable results • Strong bias for action and ability to make good calls on incomplete information • Structured problem solving and comfort with data • Ability to own a KPI dashboard, find root causes and build the case for change • SQL is a plus • Experience leading teams, ideally including offshore, distributed or vendor teams • Ability to run executive reviews, flag bad news early and arrive with a plan • Clear, concise communication up, down and across the organization • Payer enrollment, credentialing, RCM or healthcare operations experience; BPO or offshore operations management; launching a large enterprise customer; startup experience are nice to have

🏖️ Benefits

• Equity • Benefits as part of the total compensation package