Credentialing & Enrollment Lead

The role

The Credentialing & Enrollment Lead will own multi-state provider enrollment strategy end-to-end. You will shape payer relationships, contracting, and multi-state enrollment to support Medicare Advantage and Medicaid patients.

What you will do

• Own provider enrollment end-to-end for MA, Medicaid, and Original Medicare across multiple states.
• Lead credentialing strategy using CAQH, PECOS, and state Medicaid portals.
• Navigate payer contracting including fee schedules and timelines.
• Build the playbook and document processes.
• Troubleshoot and escalate stalled or denied applications.
• Advise on how PC-MSO structures, telehealth, and multi-state licensure interact with enrollment.

Required qualifications

• Experience with multi-state telehealth credentialing.
• Understanding of PC-MSO structures and their effect on payer enrollment.
• Experience working with Medicare Advantage payers and state Medicaid programs directly.
• Knowledge of CAQH, PECOS, and state Medicaid portals.
• Experience dealing with payer contracting.
• Ability to operate independently.

Nice to have

• experience with delegated credentialing
• MAC jurisdictions
• EDI enrollment

Benefits

• Meaningful early equity

About the company

Mira Mace is building an AI-powered healthcare assistant to help people navigate healthcare systems. The founding team has experience from companies like Microsoft, Google, and Meta.