Senior Manager – Payer Enrollment Operations

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the operational aspects of implementation from go-live, including establishing the team, workflows, reporting, and client interactions.

• Create tools to monitor files, identify blockers, and track commitments.

• Acquire an understanding of payer-specific requirements, revalidation processes, and follow-up procedures.

• Take responsibility for the complete delivery in accordance with contractual SLAs and SLOs.

• Act as the primary operational liaison for client stakeholders, ensuring client satisfaction and health.

• Conduct performance reviews, manage escalations, and provide weekly/monthly reports.

• Lead a combined onshore and offshore team comprising team leads, enrollment specialists, and quality analysts, including a team in India and potentially a BPO partner.

• Handle escalated enrollments and collaborate with payer relationships to address delays, rejections, and discrepancies.

• Develop capacity plans, shift coverage strategies, conduct performance reviews, and manage coaching and performance evaluations.

• Collaborate with Product and Engineering teams to automate manual tasks and minimize rework.

• Take charge of account economics, productivity metrics, automation rates, and cost to serve.

• Create playbooks for future enterprise launches.

• Assume additional enterprise clients once the account reaches stability.

• Report directly to the GM of Payer Enrollment / VP of Business Operations.

⛳️ Requirements

• Minimum of 5 years of experience in strategy & operations, BizOps, management consulting, program management, or operations leadership, preferably in a high-growth environment.

• Proven history of owning outcomes from start to finish, with measurable success.

• Strong inclination for proactive action and capability to make informed decisions with incomplete information.

• Structured problem-solving skills and comfort with data analysis.

• Ability to manage a KPI dashboard, identify root causes, and advocate for necessary changes.

• Proficiency in SQL is an advantage.

• Experience in leading teams, particularly those that are offshore, distributed, or involve vendor management.

• Capable of conducting executive reviews, promptly highlighting issues, and presenting solutions.

• Excellent communication skills, both upward and downward, across the organization.

• Experience in payer enrollment, credentialing, revenue cycle management (RCM), or healthcare operations; BPO or offshore operations management; launching large enterprise customers; and startup experience is preferred.

🏝️ Benefits

• Equity

• Comprehensive benefits as part of the total compensation package