Senior Manager / Director, Payer Enrollment Operations

About Medallion

At Medallion, we believe healthcare teams should focus on what truly matters - delivering exceptional patient care. That’s why we’ve built a leading provider operations platform to eliminate the administrative bottlenecks that slow healthcare organizations down. By automating licensing, credentialing, payer enrollment, and compliance monitoring, Medallion empowers healthcare operations teams to streamline their workflows, improve provider satisfaction, and accelerate revenue generation, all while ensuring superior patient outcomes.

As one of the fastest-growing healthcare technology companies - ranked #3 on Inc. Magazine’s 2024 Fastest-Growing Private Companies in the Pacific Region, #5 on LinkedIn's 2024 Top US Startups, a Glassdoor Best Place to Work in 2024 & 2025, and featured on The Today Show - Medallion is revolutionizing provider network management. Our CEO, Derek Lo, has been named one of the Top 50 Healthcare Technology CEOs of 2024 by The Healthcare Technology Report. Backed by $130M in funding from world-class investors like Sequoia Capital, Google Ventures, Optum Ventures, Salesforce Ventures, Acrew Capital, Washington Harbour, and NFDG, we’re on a mission to transform healthcare at scale.

We prioritize candidate safety. Please be aware that official communication will only come from @medallion.co email addresses.

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