Provider Credentialing Specialist

About us

Pomelo Care is a multi-disciplinary team of clinicians, engineers, and problem solvers passionate about improving care for women and children. We are transforming health outcomes by providing evidence-based, compassionate care.

• For pregnancy and postpartum: We deliver coordinated, virtual care at scale for pregnant people and babies. We support patients throughout pregnancy, NICU stays, and the first postpartum year, measuring our success by reductions in preterm births, NICU admissions, c-sections, and maternal mortality.
• For perimenopause and menopause: We extend that same personalized model to support women through the midlife transition. We provide expert guidance for symptom management, long-term health planning, and navigating the physical and emotional changes of menopause.

Our technology-driven care platform makes this possible, enabling us to deliver the right care at the right time, improving outcomes and reducing healthcare spend across the continuum of women's health.

Role Description

Your North Star: Work with the New Ventures team to complete health plan credentialing accurately & efficiently.

What You’ll Do

• Complete group & practitioner health plan credentialing on behalf of Pomelo’s telehealth clinic & care team.
• Track applications from submission to approval, contracting, and agreement, ensuring cross-functional visibility into key milestones & timelines.
• Proactively mitigate application delays & denials; Rigorously follow up on any delays and/or denials to right-size
• Follow up on any delays and/or denials; Proactively update workflows to Rigorously follow up with Proactively mitigate application delays & denials; Rigorously follow up on delays & denials
• Collaborate with Pomelo licensing, credentialing, and enrollment team to ensure proper clinician licensure & up-to-date CAQH profiles, to help expedite health plan credentialing
• Collaborates with care team of nurses, nurse practitioners, doctors, therapists & registered dietitians to support navigation & answer questions about clinician credentialing applications

Who You Are

• 2-4 years of experience in a high volume, credentialing specialist role
• Deep expertise with commercial health plan credentialing processes, including health plan portals & CAQH
• Highly organized with a strong attention to detail.
• A proactive and resourceful problem-solver who is comfortable navigating ambiguity and independently seeks out answers and solutions.
• An accountable and collaborative team player with excellent communication skills, both written and verbal.
• An expert at prioritization & time management, who proactively shares deliverable timelines and roadblocks

Why you should join our team

By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup where you will have a profound impact on the patients we serve. You'll also learn, grow, be challenged, and have fun with your team while doing it.

We strive to create an environment where employees from all backgrounds are respected. We value working across disciplines, moving fast, data-driven decision-making, learning, and always putting the patient first. We also offer:

• Competitive healthcare benefits
• Generous equity compensation
• Unlimited vacation
• Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)

At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.

Our salary ranges are based on paying competitively for our company’s size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care. In accordance with New York City, Colorado, California, and other applicable laws, Pomelo Care is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. A reasonable estimate of the current salary range is $55,000 - $75,000 per year. We expect most candidates to fall in the middle of the range. We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash.