About Medallion
Healthcare is going through an unprecedented transformation towards digital care. Medallion provides the critical administrative infrastructure to make that change possible. Our platform enables organizations to license their providers in new states, verify existing credentials, and get in-network with health plans. In just over three years, our platform has become an industry standard powering hundreds of healthcare companies to reduce administrative burden for tens of thousands of providers across the country. To date, Medallion has saved over 500,000 administrative hours for our customers!
Founded in 2020, Medallion has raised $85M from world-class investors like Sequoia Capital, Google Ventures, Spark Capital, Optum Ventures, and Salesforce Ventures.
About the Role:
As Medallion’s Government Relations Manager, you will play a key role in overseeing and improving provider enrollment (PE) processes, particularly within government programs like Medicaid and Medicare. You'll collaborate with both internal teams and external stakeholders to streamline workflows, resolve complex enrollment issues, and ensure compliance with government regulations.
This role reports to the Associate Director of Payer Enrollment and base compensation for this role may land between $70,000-$110,000. In addition to base salary, Medallion offers equity, and benefits as part of the total compensation package. Many factors are considered when determining pay including: market data, geographic location, skills, qualifications, experience, and level.
Responsibilities:
Serve as the subject matter expert on government relations, particularly Medicaid and Medicare, for Enterprise and Mid-Market clients, providing clear communication and expert guidance on complex regulatory matters.
Gain a deep understanding of PE team processes, workflows, and tools, and drive workflow improvements.
Stay updated on federal and state regulations related to Medicaid, Medicare, and other government payers.
Ensure that all enrollment and credentialing activities comply with government standards and internal policies.
Identify opportunities to improve the efficiency of the enrollment process, reducing turnaround times and increasing first-time approval rates.
Implement and monitor process improvements to streamline operations and enhance service delivery.
Resolve complex provider enrollment issues by coordinating with internal and external stakeholders.
Continuously learn and implement industry best practices to enhance efficiency, growth, and client outcomes.
Design and conduct training on the provider enrollment process and process improvement initiatives.
Lead communication with Enterprise and Mid-Market clients, managing regular and ad hoc client calls to ensure smooth support.
Handle additional duties as assigned.
Qualifications:
5+ years of payer enrollment experience with government programs (Medicare, Medicaid) and commercial health plans.
Strong understanding of federal and state payer regulations, including the Medicare and Medicaid enrollment process.
Experience with payer enrollment software and platforms.
Experience in a client-facing role with strong written and verbal communication skills.
Experience managing projects related to government healthcare systems.
High attention to detail and ability to communicate effectively at all levels of an organization.
Strong organizational and management skills to handle complex situations, including planning, resource allocation, and tracking.
Proficiency with Google Suite tools (GSheets, GDocs, GMail).
Nice-to-haves:
Payor contracting and/or revenue cycle experience
Provider Enrollment Specialist Certificate (PESC)
Startup experience
United States
