Associate Director – Payer and Clinical Operations
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Job Description
Payer and clinical operations leader scaling Babylist Health’s insurance-covered classes and lactation consulting. Owning compliance, credentialing, payer transitions, and operational readiness.
Responsibilities:
- Own onboarding of every new payer, including process, timelines, and cross-functional collaboration
- Keep existing payer operations running cleanly and resolve operational friction
- Ensure efficient payer AR processes, EFT setup, payment schedules, eligible sub-plan servicing, and updates to allowable amounts in systems
- Own licensing and credentialing for clinical services, including IBCLC credentialing
- Lead responses to audits, site inspections, and license renewals
- Identify and implement compliance best practices across Babylist Health
- Manage payer transitions end-to-end
- Build and maintain visibility into payer-level performance
- Program-manage daily business reporting and monitoring
- Program-manage the operational side of new launches, including new DME types and lines of business
- Manage and develop two direct reports
- Partner cross-functionally with billing/RCM, legal, product, and payer contracting teams
Requirements:
- Experience running payer operations at scale across more than one contract type or service line
- Strong knowledge of healthcare licensing and credentialing, including state licensure, site inspections, payer-level credentialing, and IBCLC credentialing
- Experience owning operational relationships with payers directly
- Experience in multi-state regulatory compliance
- Experience managing both commercial and Medicaid payer work, including Medicaid expansion into new states
- Ability to set direction and write requirements
- Strong people management, coaching, and performance management skills
- Ability to build processes for ambiguous, fast-changing operational work
- Experience operating across a large, matrixed organization
- Experience partnering with billing/RCM, legal, product, customer support, and payer contracting teams
- Comfortable using AI tools in daily work
Benefits:
- Competitive pay and meaningful opportunities for career advancement
- Career progression and performance-based advancement
- Company-paid medical, dental, and vision insurance
- Retirement savings plan with company matching
- Flexible spending accounts
- Generous paid parental leave and PTO
- Winter Wonder Week: the whole company takes a paid week off at the end of the year
- Remote work stipend to set up your office
- Perks for physical, mental, and emotional health, parenting, childcare, and financial planning
- Leading tools like Claude and ChatGPT from day one
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