Connecting you with dedicated health advocates who put you first and take charge of your healthcare journey
Credentialing & Enrollment Lead
Location
United States
Posted
8 days ago
Salary
Not specified
No structured requirement data.
Job Description
Role Description
We're looking for a Credentialing & Enrollment Lead who can own our multi-state provider enrollment strategy end-to-end. You'll be the person who tells us what to do — not the other way around.
We're a telehealth-first Medicare navigation company operating through a PC-MSO structure across multiple states. We've built the product and the clinical team. Now we need someone who deeply understands the credentialing and payer enrollment landscape to unblock our ability to serve Medicare Advantage and Medicaid patients at scale.
You'll work directly with the founders and report to the COO. This isn't a "process applications and wait" role — it's a strategic hire where you'll shape how we approach payer relationships, contracting, and multi-state enrollment.
We're a small, focused team, and this role will have a direct impact on our payer strategy, enrollment operations, and ability to scale to new states. You'll collaborate closely with leadership and our clinical team to build the credentialing infrastructure that lets us actually serve patients.
Responsibilities
- Own provider enrollment end-to-end.
- MA, Medicaid, and Original Medicare across multiple states — applications, follow-ups, and issue resolution.
- Lead credentialing strategy.
- CAQH, PECOS, state Medicaid portals — you know what needs to happen and in what order.
- Navigate payer contracting.
- Understand fee schedules, contracting timelines, and what's negotiable.
- Build the playbook.
- Document processes so enrollment doesn't live in anyone's head.
- Troubleshoot and escalate.
- Advise on structure.
Qualifications
- You've done multi-state telehealth credentialing before — not just in-person, single-location enrollment.
- You understand PC-MSO structures and how they affect payer enrollment.
- You've worked with Medicare Advantage payers and state Medicaid programs directly.
- You know CAQH, PECOS, and at least a few state Medicaid portals inside and out.
- You've dealt with payer contracting — you know what happens after credentialing.
- You can operate independently — we need someone who brings the answers, not just the questions.
- You're comfortable in a small, fast-moving team where you'll have real ownership and direct access to leadership.
- Bonus: experience with delegated credentialing, MAC jurisdictions, or EDI enrollment.
Benefits
- Mission with meaning.
- High ownership.
- Real impact.
- Grow with us.
- Meaningful early equity.
Company Description
At Mira Mace, we're building an AI-powered healthcare assistant that helps people navigate one of the most confusing systems out there.
We've felt the pain ourselves — the endless back-and-forth with insurance, surprise bills, and the lack of clarity when you just need answers. Too many people fall through the cracks, and we're determined to change that.
Our goal is simple: give people a trusted advocate who can make healthcare less exhausting and more human.
Our founding team brings a mix of strong technical experience from companies like Microsoft, Google, and Meta, along with serial startup experience ranging from early bootstrapped ventures to Series D scale-ups. We're early, focused, and building with urgency and care.
Job Requirements
- You've done multi-state telehealth credentialing before — not just in-person, single-location enrollment.
- You understand PC-MSO structures and how they affect payer enrollment.
- You've worked with Medicare Advantage payers and state Medicaid programs directly.
- You know CAQH, PECOS, and at least a few state Medicaid portals inside and out.
- You've dealt with payer contracting — you know what happens after credentialing.
- You can operate independently — we need someone who brings the answers, not just the questions.
- You're comfortable in a small, fast-moving team where you'll have real ownership and direct access to leadership.
- Bonus: experience with delegated credentialing, MAC jurisdictions, or EDI enrollment.
Benefits
- Mission with meaning.
- High ownership.
- Real impact.
- Grow with us.
- Meaningful early equity.
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