Payer Operations Lead
New
A
AllaraWomen's Health
Remote (US)Full-TimeLead
Salary$60,000-$68,000 with opportunities for advancement
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Job Details
- Experience
- 2-3 years
Requirements
- 2-3 years of experience in provider enrollment, credentialing, payer contracting, or healthcare administration.
- Demonstrated experience building or documenting processes and SOPs.
- Experience coaching, training, or quality-reviewing others' work.
- Comfort owning metrics and reporting on pipeline throughput.
- Highly independent and driven with a track record of relentless follow-up.
- Exceptional attention to detail and organizational skills.
- Hands-on experience with payer portals and third-party portals (e.g., Availity) preferred.
- Familiarity with commercial payer requirements (Medicare and Medicaid experience is a plus).
- Experience in multi-state telehealth, digital health, or high-growth healthcare environments preferred.
- Exposure to credentialing standards such as NCQA and CMS preferred.
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.
- Maintain enrollment and contracting trackers, flag delays, and escalate blockers with solutions.
- Conduct persistent follow-up with payers via phone, email, and portals to resolve deficiencies.
- Prepare, submit, and track payer contract applications for new partnerships and service lines.
- Serve as a quality and productivity coach for offshore enrollment team members.
- Assist Sr. Manager with onboarding and ramping offshore contributors.
- Partner with RCM and payer strategy/business development teams on strategic initiatives.
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