Credentialing Specialist

Credentialing Specialist

Pomelo Care is a passionate team comprising clinicians, engineers, and problem solvers dedicated to enhancing care for women and children. We are on a mission to transform health outcomes through evidence-based, compassionate approaches.

Our focus encompasses pregnancy and postpartum care, offering coordinated virtual support for both pregnant individuals and their babies. We track our success in reducing preterm births, NICU admissions, c-sections, and maternal mortality rates.

Additionally, we provide personalized support for women navigating perimenopause and menopause, offering expert guidance on symptom management, long-term health planning, and coping with physical and emotional changes.

Leveraging our technology-driven care platform, we deliver timely and effective care, improving outcomes while reducing healthcare costs across the spectrum of women's health.

What You'll Do

Facilitate group and practitioner health plan credentialing for Pomelo's telehealth clinic and care team.

Monitor application progress from submission to approval, ensuring clear visibility of key milestones and timelines across teams.

Proactively identify and address application delays and denials, maintaining rigorous follow-ups.

Collaborate with the licensing, credentialing, and enrollment teams to ensure clinicians have proper licensure and updated CAQH profiles, expediting health plan credentialing.

Work closely with a multidisciplinary care team, including nurses, nurse practitioners, doctors, therapists, and registered dietitians, to assist with clinician credentialing inquiries and navigation.

Who You Are

You have 2-4 years of experience in a credentialing specialist role in a high-volume environment.

You possess in-depth knowledge of commercial health plan credentialing processes, including health plan portals and CAQH.

You are highly organized with exceptional attention to detail.

You are a proactive problem-solver who thrives amid ambiguity and takes initiative to find answers.

You are a collaborative team player with strong written and verbal communication skills.

You excel in prioritization and time management, consistently sharing timelines and roadblocks with your team.

Why You Should Join Our Team

Joining Pomelo puts you at the forefront of a mission-driven startup, where your work will directly impact the lives of our patients. Here, you will learn, grow, face challenges, and have fun as you collaborate with your team.

We aim to foster an inclusive environment where employees from diverse backgrounds are respected and valued. Our commitment to data-driven decision-making and continuous learning ensures a holistic approach to patient care. In addition, you will enjoy:

Competitive healthcare benefits

Generous equity compensation

Unlimited vacation

Membership in the First Round Network, a community offering mentorship and resources.

At Pomelo, we believe that diverse perspectives are key to addressing the challenges we face and providing exceptional care. We encourage applications from individuals from all backgrounds, including race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.

Please note that our salary ranges reflect our commitment to equitable compensation within our industry. The estimated salary range for this role is $55,000 - $75,000 annually, with most candidates expected to fall within the midpoint of this range. We also offer options for equity versus cash compensation to suit your preferences.

Potential Fraud Warning

Please remain vigilant regarding potential recruitment fraud. With the rise of remote hiring, scams are becoming more prevalent. Pomelo Care will never request fees or personal banking information before signing an employment contract. Our communication will only come from official Pomelo Care email addresses. If you receive a suspicious message, we urge you to verify its authenticity by contacting us directly.