
PM Pediatric Care
Remote Jobs
Revolutionizing the way healthcare is delivered to babies, children, and young adults.
20 Jobs
Vice President – Head of Payer Strategy
PM Pediatric CareRevolutionizing the way healthcare is delivered to babies, children, and young adults.
• Own strategic relationships with Tier 1 payers: UnitedHealthcare, Aetna, Cigna, Anthem/BCBS, and Humana; serve as executive liaison to payer leadership at the C-suite and senior VP levels • Negotiate multi-year rate renewals, expand geographic coverage, and improve contract terms including facility fees, after-hours differentials, and coding/billing policies • Lead escalation management: resolve contract disputes, address network adequacy issues, and navigate audit and compliance challenges • Translate clinical quality, patient satisfaction, and cost-effectiveness into compelling payer value propositions • Analyze rate structures, benchmark against market, and identify opportunities for rate improvement • Accelerate behavioral health payer contracting in NY, NJ, and FL, and lead payer entry into 6+ new states over 24 months • Negotiate rates, terms, and coverage policies that support financial sustainability, with a target of $200K–$280K revenue per clinical FTE • Lead payer credentialing and network inclusion strategy for therapists, psychiatrists, and psychiatric NPs across multiple states; drive credentialing cycle time to under 45 days • Design and execute a behavioral health payer entry playbook covering market landscaping, contract negotiation sequencing, credentialing project management, and post-contract optimization • Evaluate and build value-based care partnerships: shared savings, bundled payments, quality incentive programs, and outcomes-based contracts • Build payer performance dashboards tracking contract utilization, revenue per contract, payer mix, claims denial rates, and financial performance by payer • Develop negotiation playbooks, contract templates, and rate benchmarking tools to scale the payer strategy function • Build and lead the payer strategy team as the organization scales, including future hires in payer contracting, credentialing, and analytics • Drive $15M–$25M in cumulative revenue impact through contract optimization, new payer partnerships, and value-based upside
Senior Director, Product Management – Patient Experience
PM Pediatric CareRevolutionizing the way healthcare is delivered to babies, children, and young adults.
• Design a system to automatically track every inbound referral • Map and redesign the end-to-end journey for every channel type based on patient journey • Partner with Technology and marketing to architect the platform layer • Define and enforce experience design standards • Own the business strategy and experience design for all inbound and outbound channels • Lead the strategic design and operational blueprint for PM Pediatrics' hospital partnerships
Social Determinants of Health Screening Care Coordinator
PM Pediatric CareRevolutionizing the way healthcare is delivered to babies, children, and young adults.
Role Description This is a remote position. The SDOH Care Coordinator is a new, centralized virtual role supporting PM Pediatric Care’s Social Determinants of Health screening and referral programs across six states. Working through the Findhelp platform, you will serve as the hub connecting Medicaid families with community resources. - Enter SDOH assessment results into the Findhelp platform for Medicaid members across TX, MD, DC, NY, VA, and FL. - Verify patient Medicaid eligibility through the Findhelp portal prior to assessment submission. - Place e-referrals to community-based organizations (CBOs) across need categories including food, housing, transportation, childcare, utilities, and other social supports. - Follow up with families to confirm referral outcomes and support closed-loop communication with CBOs. - Coordinate with front desk staff across multiple offices to support screening workflows, troubleshoot platform issues, and share best practices. - Support front desk training initiatives related to SDOH screening processes and Findhelp platform navigation. - Identify and escalate technical issues with the Findhelp platform to ensure minimal disruption to program operations. - Contribute to continuous improvement efforts aimed at increasing screening rates, referral conversion, and patients getting help across all participating states. This is a grant funded role. The compensation target for this role is $22.00 - $25.00 per hour. The salary/rate range listed here has been provided to comply with local regulations and represents a potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. We look at compensation for each individual and based on experience and qualifications. Qualifications - Bachelor’s degree in social work, public health, community health, human services, or a related field; OR certification as a Community Health Worker (CHW) with relevant professional experience. - Minimum of 2 years of experience in care coordination, community health, social services, or a related role with direct family engagement around social needs. - Demonstrated understanding of social determinants of health frameworks and their impact on pediatric populations. - Proficiency with web-based platforms and data entry; comfort learning new technology tools quickly. - Strong verbal and written communication skills, with the ability to engage diverse and underserved populations with empathy and cultural sensitivity. - Ability to work independently in a fully remote setting, managing priorities across multiple states and time zones. - Reliable internet connection and a dedicated home workspace conducive to a professional virtual work environment. - Bilingual fluency in Spanish and English. - Experience working with pediatric or maternal-child health populations. - Experience working with Medicaid-insured populations or within Medicaid managed care programs. - Familiarity with the PRAPARE screening tool or similar SDOH assessment instruments. - Experience using the Findhelp (formerly Aunt Bertha) platform or similar community resource referral systems. - Knowledge of community-based organizations and social service networks in TX, MD, DC, NY, VA, or FL. Benefits - Comprehensive benefits package including health insurance, paid time off, and 401(k). - A fully remote position with schedule flexibility. - The opportunity to be part of a nationally recognized, award-winning SDOH program making a tangible difference in children’s lives. - Career growth potential within a fast-growing organization committed to promoting from within. - A culture of inclusiveness, collaboration, and passion for pediatric healthcare. Compensation Compensation Dependent Upon Location and Experience. The salary/rate range listed here has been provided to comply with local regulations and represents a potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. We look at compensation for each individual and based on experience and qualifications. EEO Statement PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.
Mental Health Patient Coordinator
PM Pediatric CareRevolutionizing the way healthcare is delivered to babies, children, and young adults.
Title: Mental Health Patient Coordinator - Remote - Full Time Location: Remote - New York time type Full time job requisition id 2026-R0626 It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Summary *Compensation range: $48,000 - $53,000 (dependent upon relevant experience)* *Schedule: Mondays, Tuesdays, Wednesdays: 10:00am - 6:00pm EST; Thursdays & Fridays: 8:00am - 4:00pm EST* The Mental Health Patient Coordinator coordinates all appointments with providers for patients, referring physicians, and facilities across multiple states. In addition, the Patient Engagement Specialist communicates key information to patients and staff members including insurance coverage, financial responsibilities, and date/time of appointments. Description - Provide warm, friendly, and excellent customer service through all interactions with patients, referral sources and staff members. - Communicate directly with patients to schedule, re-schedule and/or cancel their initial and subsequent appointment requests accurately by following practice scheduling protocols and tools. - Provide accurate and courteous information regarding our services to physicians and other callers. - Respond effectively and promptly to all patient, provider, and team member requests. - Maintain/Update patient information and working knowledge of insurance protocols. - Utilizes eligibility systems, on-line websites or phone calls to determine insurance benefits. - Provides information to the patient and/or guarantors regarding their benefits and financial obligations. - Handle billing inquiries, collect any out of pocket (deductibles, copays, etc), and process payments accurately. - Explain insurance coverage and financial responsibility to patients in clear language. - Communicate when insurance issues arise (inactive coverage, referral needed, etc.) - Work with billing teams to correct coverage issues. - Maintain insurance panels. - Obtain approval for schedule changes or cancellations as appropriate. - Meet specified goals and objectives assigned by management. - Escalate any problems that may arise to management. - Complete other duties as assigned or identified based on patient needs. - Ability to adhere to quality and productivity standards. Qualifications - Experience with insurance eligibility. - Bilingual Spanish Preferred. - Bachelor’s degree preferred. - Attention to detail a requirement. - Strong organizational skills. - Ability to multi-task and prioritize. - Ability to work well with others in a team driven environment. Compensation: Role Dependent The salary/rate range listed here has been provided to comply with local regulations and represents a potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. We look at compensation for each individual and based on experience and qualifications. EEO Statement PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.
Mental Health Nurse Practitioner
PM Pediatric CareRevolutionizing the way healthcare is delivered to babies, children, and young adults.
Title: Mental Health Nurse Practitioner (NY) Location: Remote - United States Full time Job Description: It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Summary This is a remote role PM Pediatric Care is seeking a psychiatric nurse practitioner for the psychopharmacology role with experience in adolescent and adult behavioral health needs to join our virtual Behavioral Health Program. This unique opportunity will provide comprehensive behavioral health support for adults and adolescents, addressing common conditions such as depression, anxiety, ADHD, and mood disorders through an extended virtual care model. Part Time (20 hours per week) and Full Time positions available! Part Time and Full Time positions are benefits eligible! Description - Work as part of the virtual behavioral health team, providing patient services using evidence-based medicine - Diagnose and assess mental/behavioral health disorders for pediatric, adolescent and young adult patients; formulate differential diagnoses - Demonstrate appropriate clinical judgement in assessment and treatment, following established clinical care guidelines - Collaborate and communicate with therapist team and medical leadership to discuss patient treatment plans - Order and interpret diagnostic tests when appropriate - Conduct patient history and initial evaluations of incoming patients - Prescribe medications as part of the patient’s treatment regime as allowed by license - Provide both medication management and counseling for patients - Educate patient and parent on medication side effects, risk/benefits and proper usage of new medication and reasonable outcome expectations of medications - Establish and modify patient treatment plan based on clinical assessment and re-assessment with screening tools - Appropriately document each patient visit in the electronic medical record, including subjective and objective data, assessments, treatment plan, and other documentation as necessary - Communicate patient’s plan of care with behavioral health team and patient’s primary care physician - Work with members of the healthcare team in educating the patients of their medical care - Continually update clinical knowledge and skills through consultation, formal and informal education and review of literature for the benefit of themselves as well as for the healthcare team - Provide appropriate referrals when necessary - Bilingual Spanish skills are a plus Compensation range: $100.00 - $110.00 an hour The salary/rate range listed here has been provided to comply with local regulations and represents a potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. We look at compensation for each individual and based on experience and qualifications. Qualifications EDUCATION/TRAINING - Successful completion of advanced practitioner training and certification from an approved nurse practitioner program - Minimum three years of psychiatric experience in a clinical setting plus two years of nurse practitioner experience - Licensed as an advanced registered nurse practitioner with prescriptive authority in the state practicing QUALIFICATIONS - Strong organizational and time management skills - Strong verbal and written communication skills - Ability to screen for danger to self or others - Demonstrated adherence to acceptable ethical and behavioral standards of conduct - Ability to collaborate with strong skills working with a team - Experience working specifically with children and adolescents - Prior experience with use of electronic health records REQUIRED LICENSES/CERTIFICATIONS - Masters of Arts in Psychiatric/Mental Health/Nursing - Advanced Practice Nurse (APN) - Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC) - Must hold an active New York license; New Jersey licensure is strongly preferred. A current New York DEA license is required. Compensation: $65 - $100/hour The salary/rate range listed here has been provided to comply with local regulations and represents a potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. We look at compensation for each individual and based on experience and qualifications.
Mental Health Patient Coordinator
PM Pediatric CareRevolutionizing the way healthcare is delivered to babies, children, and young adults.
Role Description The Mental Health Patient Liaison coordinates all appointments with providers for patients, referring physicians, and facilities across multiple states. In addition, the Liaison communicates key information to patients and staff members including insurance coverage, financial responsibilities, and date/time of appointments. - Provide warm, friendly, and excellent customer service through all interactions with patients, referral sources, and staff members. - Communicate directly with patients to schedule, re-schedule and/or cancel their initial and subsequent appointment requests accurately by following practice scheduling protocols and tools. - Provide accurate and courteous information regarding our services to physicians and other callers. - Respond effectively and promptly to all patient, provider, and team member requests. - Maintain/Update patient information and working knowledge of insurance protocols. - Utilize eligibility systems, online websites, or phone calls to determine insurance benefits. - Provide information to the patient and/or guarantors regarding their benefits and financial obligations. - Handle billing inquiries, collect any out of pocket (deductibles, copays, etc.), and process payments accurately. - Explain insurance coverage and financial responsibility to patients in clear language. - Communicate when insurance issues arise (inactive coverage, referral needed, etc.). - Work with billing teams to correct coverage issues. - Maintain insurance panels. - Obtain approval for schedule changes or cancellations as appropriate. - Meet specified goals and objectives assigned by management. - Escalate any problems that may arise to management. - Complete other duties as assigned or identified based on patient needs. - Ability to adhere to quality and productivity standards. Qualifications - Experience with insurance eligibility. - Bilingual Spanish preferred. - Bachelor’s degree preferred. - Attention to detail a requirement. - Strong organizational skills. - Ability to multi-task and prioritize. - Ability to work well with others in a team-driven environment. Requirements - Compensation Dependent Upon Location and Experience. - The salary/rate range listed here has been provided to comply with local regulations and represents a potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. - We look at compensation for each individual based on experience and qualifications. EEO Statement PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.
Pediatric Urgent Care Advanced Practice Provider
PM Pediatric CareRevolutionizing the way healthcare is delivered to babies, children, and young adults.
Role Description PM Pediatric Care is hiring Advanced Practice Providers (APPs) with significant pediatric or urgent care/ER experience to join our team. Under the guidance of the Regional Medical Officer, APPs are responsible for evaluating and providing evidence-based treatment to pediatric patients in an urgent care setting. - Provide expert assessment and treatment of acute injuries and illnesses for both in-person and telemedicine patients, including but not limited to: - Management of the febrile infant/child - Ear/nose/throat infections - Pediatric abdominal pain - Anaphylaxis - Procedural anxiolysis - Respiratory distress - Croup - Asthma - Perform common urgent care procedures, including but not limited to: - Abscess drainage - Foreign body removal - Laceration repair with sutures, staples, and dermal adhesive - Obtain and provide preliminary interpretation of radiographs with radiologist over-reads (only in applicable states). All necessary training will be provided. - Oversee daily operations and patient flow for both in-person and telemedicine visits, with oversight of other providers, staff, and trainees on shift. - Ensure efficient operations by adhering to established policies and procedures and proactively report any necessary changes to the management team. - Collaborate with both on-site and telemedicine teams to assure completion of daily tasks, including but not limited to: - Lab and radiology result review - Patient follow-up - Timely responses to patient calls and questions - Promote a safe, secure, equitable, and healthy work environment by enforcing safety protocols, upholding quality standards, and ensuring compliance with legal regulations. - Maintain patient confidence and protect operations by keeping patient care information confidential in compliance with HIPAA regulations. - Update knowledge and skills through our internal training program, continuing education opportunities, professional publications, and participation in professional organizations. - Actively contribute to service recovery efforts by assisting staff and patients with complaints. - Focus on efficiency metrics to improve in-person and telemedicine urgent care flow, antibiotic stewardship, and patient experience. Qualifications - Pediatric experience is required; Pediatric ER, General Pediatrics, or Urgent Care Experience preferred. - Active ANCC Board Certification or NCCPA Certification. - Active RN (if applicable) and NP/PA state license for each state where treating patients. - Master of Science in Nursing or Doctoral degree in Nursing or Master of Physician Assistant Studies required. - Minimum 2 years of independent pediatric clinical experience as an APP (outside of rotations) or at least 1 year in urgent care or emergency medicine. - Ability to think critically, multitask, and work as part of a multidisciplinary team. - Excellent computer skills and experience with EMR (eCW experience preferred). - Ability to effectively communicate both verbally and nonverbally. Requirements - Compensation: $110,000 - $175,000. The salary/rate range listed here has been provided to comply with local regulations and represents a potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. EEO Statement PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.
Licensed Master Social Worker
PM Pediatric CareRevolutionizing the way healthcare is delivered to babies, children, and young adults.
Title: Licensed Master Social Worker (NY) - Remote - Full Time or Part Time Location: Remote - New York Full time Job Description: It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Summary PM Pediatric Care is seeking a Licensed Master Social Worker to join our Behavioral Health Program. This opportunity will provide comprehensive behavioral health for the common conditions seen in primary care such as depression, anxiety, ADD, and conduct disorders in an extended primary care collaborative model. **For Full Time, the pay range for this position is $65,000-$70,000 + medical benefits + PTO** (compensation dependent on licensure & experience) **2 Flexible Schedule options: 5 days 1:00pm-9:00pm M-F; or 4 10 hour days, 2 days 11:00am - 9:00pm, 2 days 8:00am - 6:00pm** or can use 9:00am-3:00pm on Saturdays; Part Time positions = 20 hours per week (benefits eligible!!) Founded in 2006, PM Pediatrics is the nation’s largest pediatric urgent care provider as well as a national telehealth company expanding services to meet all of the physical, behavioral, and psychosocial needs of children. Description - Perform psychosocial assessments that comply withevidence based practices - Providing counseling and therapy for patients using evidence based treatment modalities - Display competency as an individual, family, and group therapist - Maintain own professional development as required by licensing board - Complete required documentation and paperwork, including biopsychosocial assessments and treatment planning and implementation in a timely manner - Works closely with patient and family and team to overcome obstacles in treatment - Maintain compliance with all company policies and procedures - Demonstrates cultural competency and commitment - Respond quickly to an urgent or emergent need - Maintain a caseload of 30-35 patients weekly and a minimum of 5 patients daily Compensation Range: $65,000-$70,000 The salary/rate range listed here has been provided tocomply withlocal regulations andrepresentsa potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. We look at compensation for each individual andbasedon experience and qualifications. Qualifications - Master’s Degree in Social Work or a related field required - Relevant therapist license in the state(s) practicing (LMSW- NY) - MUST have experience with pediatric and adolescent patients - Experience providing teletherapy to children and adolescents preferred - Knowledge of medical terminology - Ability to effectively interact, work, and develop meaningful relationships with people of various cultural backgrounds - Knowledge of the psychosocial aspects of illness and health - Strong verbal and written communication skills - Excellent short-term counseling skills - Experience with discharge planning Compensation: $70,000 - $75,000 The salary/rate range listed here has been provided to comply with local regulations and represents a potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. We look at compensation for each individual and based on experience and qualifications. EEO Statement PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.
Pediatric Urgent Care Physician Assistant - Tarzana, CA - (Per Diem)
PM Pediatric CareRevolutionizing the way healthcare is delivered to babies, children, and young adults.
It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Summary There’s nothing more fulfilling than working with likeminded people who truly BELIEVE in what they're doing! We're committed to bringing world class evidence based pediatric medicine and an exceptional patient experience to the practice of urgent care medicine. PM Pediatric Care is the largest pediatric urgent care network in the country. The company was founded and is still led by pediatric emergency physicians with a mission to provide a top quality, convenient and accessible alternative to the emergency department for children and young adults. We are academically driven with >50 practice guidelines, CME-accredited lectures/workshops, a national annual conference, and a wealth of available data for research and clinical analytics. We offer a supportive work environment with comprehensive individualized learning programs for pediatric advanced practice providers, including procedural training, radiology interpretation, and evidence-based approach to illness/injury. PM Pediatric Care is set up like an ED but in a private practice setting with x-ray and lab services on site, great support staff, specialty consultations when necessary (i.e., plastic surgery, orthopedics), and high acuity with a diverse case mix. PM Pediatric Care also enjoys a solid relationship with the local communities, maintaining an outstanding reputation with both patients and their primary care providers. The work schedule is flexible with no overnights! A variety of roles are available where you can choose to work anywhere from 12-36 hours per week (PT/FT). Description PM Pediatric Care is hiring Advanced Practice Providers with pediatric experience to join our team. Under the guidance of the Regional Medical officer, APPs are responsible for evaluating and providing evidence-based treatment to pediatric patients in an urgent care setting. Job Responsibilities: - Assess and treat acute injury and illness for both in-person and telemedicine patients; including but not limited to the management of the febrile infant/child, ear/nose/throat infections, pediatric abdominal pain, anaphylaxis, procedural anxiolysis, respiratory distress, croup, and asthma. - Perform procedural care including but not limited to abscess drainage, foreign body removal, and laceration repair with sutures, staples, and dermal adhesive. - Take radiographs and provide preliminary interpretation of x-rays with official radiology over-reads (only in applicable states). All necessary training will be provided. - Oversee in-person and telemedicine patient flow and daily functions of the office along with oversight of other providers, staff, and trainees on shift. - Maintain operations by following policies and procedures; reporting needed changes to the management team. - Work in conjunction with the onsite and telemedicine teams to assure completion of daily tasks including but not limited to lab and radiology result review, patient follow-up, and timely responses to patient calls and questions. Maintains safe, secure, equitable, and healthy work environment by following and enforcing safety procedures, quality standards, and complying with legal regulations. - Maintain patient confidence and protect operations by keeping patient care information confidential in compliance with HIPAA regulations. - Update knowledge and skills through our internal training program, continuing education opportunities, professional publications and participation in professional organizations. - Assist the clinical team and patients with complaints and take an active role in service recovery when needed - Focus on efficiency metrics to improve in-person and telemedicine urgent care flow, antibiotic stewardship, and patient experience. Qualifications PM Pediatric Care seeks dynamic people who are motivated, energetic, and passionate about pediatric healthcare and believe in our mission. At PM Pediatric Care, we provide the highest quality of care in a warm child-friendly environment. Our employees are expected to deliver impeccable customer service and treat all patients as if they are family. - Ability to critically think, multitask, and work as part of a multidisciplinary team - Excellent computer skills and experience with EMR (eCW experience preferred) - Pediatric experience is required; Pediatric ER, Pediatric Hospitalist, or Pediatrics Urgent Care Experience preferred - Active ANCC Board Certification or NCCPA Certification - Active RN (if applicable) and NP/PA state license for each state where treating patients - Master of Science in Nursing or Doctoral degree in Nursing or Master of Physician Assistant Studies required - Ability to effectively communicate both verbally and nonverbally Compensation: $70 - $90/hour The salary/rate range listed here has been provided to comply with local regulations and represents a potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. We look at compensation for each individual and based on experience and qualifications. EEO Statement PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.
Provider Credentialing & Enrollment Specialist
PM Pediatric CareRevolutionizing the way healthcare is delivered to babies, children, and young adults.
It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Summary **This is a part-time, temporary position with the potential to transition into a full-time role** **This is a remote position** We are seeking a detail-oriented Credentialing & Enrollment Specialist to support provider enrollment, revalidation, and ongoing maintenance across multiple payors and states. This role focuses on resolving enrollment issues, reducing denials, and ensuring timely provider participation and reimbursement. Description Credentialing & Enrollment Support - Review and resolve enrollment with focus on state-specific requirements. - Identify and trend denial patterns to prevent recurrence (e.g., taxonomy mismatches, missing DEA, non-participating providers, admitting privileges). - Review Medicaid applications, revalidations, and facility enrollments at both group and individual levels. - Support NY ETIN and ETINS processing as required. Roster & Reporting Management - Prepare and submit monthly rosters and uploads, including new provider additions and terminations. - Manage delegated rosters such as NY-NJ Fidelis and submissions through 3rd party vendor Medallion platform Compliance & Payor Requirements - Track and resolve payors pending over 90 days and identify roadblocks. Communication & Administrative Support - Manage incoming emails and correspondence and confirm appropriate mail types and follow-up actions. - Support telehealth enrollment workflows and system integrations. - Assist with administrative tasks, documentation, and audit readiness. Performance & Process Improvement - Ensure requests submitted through 3rd party vendor Medallion are timely and accurate. - Collaborate with leadership to identify root causes of delays and prevent recurrence. Qualifications - Experience minimum two years in provider credentialing and enrollment, including Medicaid/revalidations/ETIN certifications for NY/NJ states - Knowledge of CAQH, Application utilizing our 3rd party vendor platform-Medallion - Strong attention to detail and analytical skills. - Ability to manage multiple priorities in a fast-paced environment EEO Statement PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.
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