Senior Manager / Director, Payer Enrollment Operations

About the Role

 

Medallion's Payer Enrollment team gets providers enrolled with health plans so they can see patients and get paid. We're bringing on a large enterprise customer, and we're looking for an operator to help launch the client successfully.In the near term, you'll be the dedicated lead for this new client. You'll stand up the team, launch the account, and run it day to day against demanding SLA and quality commitments. Once it's running well, your scope grows to a portfolio of enterprise clients. Think of it as a GM seat for a book of business: the client relationship, an on/offshore team, the metrics, and a mandate to make the operation faster, higher quality and more automated over time.Payer enrollment or healthcare experience is a real plus, but what matters most is that you've run complex, metrics-driven work, you move fast without waiting for a playbook, and you know how to get things done across teams.

 

This role reports to the GM of Payer Enrollment / VP of Business Operations.

 

What You'll Do

Launch the account

• Lead the operational side of implementation through go-live, standing up the team, workflows, reporting and client cadence with Implementation, Product and Engineering
• Build the instrumentation from day one, so you know where every file is, what's blocked and on whom, and how you're tracking against every commitment
• Get to working depth on payer-specific requirements, revalidation and follow-up quickly, so you can make sound calls on the work and not just the metrics

Run it

• Own end-to-end delivery against contractual SLAs and SLOs, including submission turnaround, submission quality, deficiency response and revalidation timeliness
• Serve as the operational point of contact for client stakeholders, with ownership of overall client health and satisfaction. Run recurring performance reviews, own escalations and help deliver weekly/monthly reporting
• Lead a dedicated on/offshore team of team leads, enrollment specialists and quality analysts, including our team in India and potentially a BPO partner whose performance you'll manage to SLA
• Roll up your sleeves on the most escalated enrollments, and partner with our payer relationships team to resolve systemic delays, rejections and discrepancies
• Build the operating rhythm: capacity plans, shift coverage, daily and weekly performance reviews, coaching and performance management

Build leverage

• Find where handoffs break, where work is manual and where rework piles up, then partner with Product and Engineering to automate or remove it
• Own the account's economics, including productivity, automation rate and cost to serve, and push them in the right direction every quarter
• Turn what you learn into playbooks that make the next enterprise launch faster

Grow the portfolio

• Once the account is stable, take on additional enterprise clients 

 

What We're Looking For

• 5+ years in strategy & operations, BizOps, management consulting, program management or operations leadership, ideally in a high-growth company
• A track record of owning outcomes end to end, such as something you launched, fixed or scaled, with the numbers to show for it
• A strong bias for action. You make good calls on incomplete information, move quickly and course-correct without drama
• Structured problem solving and comfort in the data. You can own a KPI dashboard, find the root cause and build the case for change (SQL a plus)
• Experience leading teams, ideally including offshore, distributed or vendor teams
• Client presence. You can run an executive review, flag bad news early and arrive with a plan
• Clear, concise communication up, down and across the organization
• Nice to have: payer enrollment, credentialing, RCM or healthcare operations experience; BPO or offshore operations management; launching a large enterprise customer; startup experience.

 

Compensation:

Base compensation for this role may land between $100,000 and $200,000. In addition to base salary, Medallion offers equity and benefits as part of the total compensation package. Many factors are considered when determining pay, including market data, geographic location, skills, qualifications, experience and level.

We prioritize candidate safety. Official communication will only come from @medallion.co email addresses.

 

 

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