Credentialing & Enrollment Lead

About the Company

Mira Mace is building an AI-powered healthcare assistant that helps people navigate the complexities of the healthcare system. Our goal is to provide a trusted advocate to make healthcare less exhausting and more human, helping patients avoid unnecessary costs and access the care they need.

Responsibilities

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

Requirements

• Experience with multi-state telehealth credentialing
• Understanding of PC-MSO structures and their effect on payer enrollment
• Direct experience with Medicare Advantage payers and state Medicaid programs
• Proficiency with CAQH, PECOS, and state Medicaid portals
• Experience with payer contracting processes
• Ability to operate independently in a fast-moving startup environment

Preferred Qualifications

• Experience with delegated credentialing
• Knowledge of MAC jurisdictions
• Experience with EDI enrollment

Benefits

• High ownership and ability to define functions from the ground up
• Real impact on patient care and company scaling
• Meaningful early equity