Job details

Manager Operations, Payer Enrollment (Government Relations)

Operations

Remote (United States)

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 No. 3 on Inc. Magazine’s 2024 Fastest-Growing Private Companies in the Pacific Region, No. 5 on LinkedIn's 2024 Top Startups in the US, a Glassdoor Best Place to Work in 2024, and featured on The Today Show—Medallion is revolutionizing provider network management. Backed by $85M in funding from world-class investors like Sequoia Capital, Google Ventures, Optum Ventures, and Salesforce Ventures, we’re on a mission to transform healthcare at scale.

About the Role:

As Medallion’s Government Relations Manager, you will play a key role in overseeing and improving provider enrollment (PE) processes, particularly within government programs like Medicaid and Medicare. You'll collaborate with both internal teams and external stakeholders to streamline workflows, resolve complex enrollment issues, and ensure compliance with government regulations. This role does not have any direct reports.

This role reports to the Associate Director of Payer Enrollment and base compensation for this role may land between $70,000-$100,000. 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.

Responsibilities:

Serve as the subject matter expert on government relations, particularly Medicaid and Medicare, for Enterprise and Mid-Market clients, providing clear communication and expert guidance on complex regulatory matters.
Gain a deep understanding of PE team processes, workflows, and tools, and drive workflow improvements.
Stay updated on federal and state regulations related to Medicaid, Medicare, and other government payers.
Ensure that all enrollment and credentialing activities comply with government standards and internal policies.
Identify opportunities to improve the efficiency of the enrollment process, reducing turnaround times and increasing first-time approval rates.
Implement and monitor process improvements to streamline operations and enhance service delivery.
Resolve complex provider enrollment issues by coordinating with internal and external stakeholders.
Continuously learn and implement industry best practices to enhance efficiency, growth, and client outcomes.
Design and conduct training on the provider enrollment process and process improvement initiatives.
Lead communication with Enterprise and Mid-Market clients, managing regular and ad hoc client calls to ensure smooth support.
Handle additional duties as assigned.

Qualifications:

5+ years of payer enrollment experience with government programs (Medicare, Medicaid) and commercial health plans.
Strong understanding of federal and state payer regulations, including the Medicare and Medicaid enrollment process.
Experience with payer enrollment software and platforms.
Experience in a client-facing role with strong written and verbal communication skills.
Experience managing projects related to government healthcare systems.
High attention to detail and ability to communicate effectively at all levels of an organization.
Strong organizational and management skills to handle complex situations, including planning, resource allocation, and tracking.
Proficiency with Google Suite tools (GSheets, GDocs, GMail).

Nice-to-haves: