Associate Director, Payer and Clinical Operations

Job description

What the Role Is

Babylist Health is scaling past DME into insurance-covered classes and lactation consulting, and we need a seasoned operations leader who can build the rigorous operational and compliance foundation that enables the business to scale safely and effectively. The Payer and Clinical Operations Associate Director owns that foundation — making sure new payers go live smoothly, existing payer operations run without disruption, and every license and credential tied to our clinical services is valid, current, and audit-ready.

You’ll manage a high performance team that delivers both quality and operational excellence. You're the first call when an audit, site inspection, or major payer transition lands, and the person tracking payer-level performance closely enough to catch operational problems before they become incidents. This role reports to the GM of Babylist Health and leads a team of two.

This role works closely with our billing/claims (RCM), product, and customer support functions— you own the operational compliance side of payer and clinical work, and partner closely with these teams day to day.

Who You Are

• You've run payer operations at scale, across more than one contract type or service line — bringing new payers live on schedule, managing transitions, and keeping existing contracts in good standing.

• You know healthcare licensing and credentialing well enough to own it without doing it yourself — state licensure, site inspections, payer-level credentialing. You've built or bought the capacity to execute, and stayed accountable for it being right.

• You've owned the operational relationship with payers directly — you've been in the room when something urgent lands, not briefed on it afterward.

• You've worked in multi-state regulatory compliance and can translate rule changes into process, documentation, and record-keeping that people actually follow.

• You've managed both commercial and Medicaid payer work, including Medicaid expansion into new states.

• You set direction and write requirements, rather than waiting for someone else to define the roadmap.

• You're a strong people manager who can coach and performance manage, and you stay close enough to the work to catch problems early.

• You build process rather than follow it — you bring order to ambiguous, fast-changing operational work, and leaders can tell at a glance where things stand.

• You operate comfortably across a large, matrixed organization — partnering daily with billing and RCM, legal, product, and customer support without owning any of those functions.

• You naturally reach for AI in your work — at Babylist, every team uses AI daily. You're already using it to move faster and improve your output, and you stay curious about what's coming next.

How You Will Make An Impact

• Own the onboarding of every new payer — a smooth go-live is your responsibility, you own the process, the timeline and the cross functional collaboration to ensure the business is ready to service new payers on time and in full

• Keep existing payer operations running clean, catching and fixing friction before it becomes a pattern. Examples include ensuring payers have efficient AR processes (EFT set up, payment schedules), ensuring we are servicing all eligible sub-plans, staying on top of changing allowable amounts and perpetuating these through our systems etc.

• Own licensing and credentialing for our clinical services, including IBCLC credentialing, as we expand into classes and lactation consulting — every license current, every credential valid, every renewal ahead of deadline.

• Lead the response when an audit, site inspection, or license renewal lands — you're the point of contact, and leading the response

• Lead identification and implementation of compliance best practices across the Babylist Health org

• Manage payer transitions end-to-end, including major payer changes, with a clear plan and clear communication to stakeholders.

• Build and maintain visibility into payer-level performance — where things are working, where they're not, and what needs attention next.

• Program-manage both day to day reporting and monitoring of the business as well as the operational side of new launches, such as launching new DME types, new lines of business etc.

• Manage and develop two direct reports, building a team that scales with the business.

• Partner cross-functionally with billing/RCM, legal, product and the payer contracting team — you own operations and compliance to facilitate their work

Why This Role

• Babylist Health is scaling into classes and lactation consulting right now — you're building the operational and compliance playbook while it still doesn't exist, not maintaining one someone else wrote.

• You'll lead a team from day one, with a direct line to the GM of Babylist Health.

• The scope is broad and real: licensing, credentialing, audits, payer transitions, and program management for new lines of business

Prepare for the interview

Nothing collected for this employer yet. The Blind 75 is what technical screens draw from; practise it here, with a coach, in Java or Python.

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