Logo for Babylist

Associate Director, Payer and Clinical Operations

Role overview

Qualifications

  • Experience running payer operations at scale
  • Knowledge of healthcare licensing and credentialing
  • Ability to manage commercial and Medicaid payer work
  • Strong people management skills

Responsibilities

  • Own the onboarding of new payers and manage existing payer operations
  • Own licensing and credentialing for clinical services
  • Lead response to audits and inspections
  • Manage payer transitions and program management for new launches

Key facts

  • Remote from: United States
  • Full time
  • Clinical Research Associate
  • English

Hard skills

Other skills

  • Program Management
  • People Management
  • Problem Solving
  • Communication

About the company

Babylist logo

Babylist

Retail – Supermarkets & Hypermarkets

At Babylist, our mission is to take care of growing families so they can be confident, connected, happy, and healthy. We're the leading digital destination for growing families, which offers the best baby gear that's expert-selected and real-parent tested. Our vision is to support every baby and the people who love them—from hoping and dreaming, through kindergarten and beyond.

Company details

Company typeSME
IndustryRetail – Supermarkets & Hypermarkets
Company size51 - 200

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

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 all sit with you — not split across five different roles.
  • This is one of the moments that determines whether growth actually happens — the business can't scale into Medicaid and new clinical services without operations that hold up.

About Compensation

We use a market-based approach to compensation. The starting salary range for this role is:

$133,567 to $178,118

Your starting salary will be based on your location, experience, and qualifications, with increases over time tied to performance, role growth, and internal pay equity.

Who We Are

Babylist is the leading platform for expecting and new families. More than 10 million people shop with Babylist every year, making it the go-to destination for seamless purchasing, guidance, and expert recommendations. As a modern, AI-forward tech company, Babylist has expanded from a universal registry into a full ecosystem — the Babylist Shop, Babylist Health, Babylist Money, NYC and LA showrooms, branded content, and more — generating $750M in revenue in 2025. Building the generational brand in baby, Babylist is reshaping the $235B kids and baby market and helping parents feel confident, connected, and cared for at every step.

Our Ways of Working

Babylist is remote-first with team members across the U.S. and Canada who move fast, think smart, and use AI as part of how they work every day — not as an experiment, as an expectation. We come together twice a year to build the relationships behind the work, and we hire people who are genuinely excited about what's possible and prove it through how they show up.

Why You Will Love Working At Babylist

Our Culture

  • We work with focus and intention, then step away to recharge
  • We believe in exceptional management, and we invest in the tools and the time to connect with colleagues
  • We build products that positively impact millions of people's lives
  • AI is part of how we work, not a side experiment. You'll have leading tools like Claude and ChatGPT from day one, with no waiting on access, so the busywork gets handled and your judgment goes where it counts

Growth & Development

  • Competitive pay and meaningful opportunities for career advancement
  • We believe technology and data can solve hard problems
  • We're committed to career progression and performance-based advancement

Benefits

  • Company-paid medical, dental, and vision insurance
  • Retirement savings plan with company matching and 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, whether or not you celebrate anything, so everyone's out at once and comes back refreshed
  • Remote work stipend to set up your office
  • Perks for physical, mental, and emotional health, parenting, childcare, and financial planning

Important Notices

Recorded Interviews. Babylist uses an interview recording tool to record and transcribe interviews for evaluation purposes in accordance with applicable privacy laws. By participating in an interview, you consent to this recording and transcription.

Interview Integrity. AI is part of how we work at Babylist. We expect you to use it too. Your application and interviews should still reflect you and your own thinking. We'll tell you when AI is encouraged. Misrepresentation at any stage may result in removal from consideration for this and future roles.

How We Review Applications We use AI throughout our hiring process to help review, screen, and assess applications. These tools support our team's review; they do not replace it, and every hiring decision is made by a person.

Connections at Babylist. If you have a family member or close personal relationship with a current Babylist employee, please let your recruiter know. This helps us keep our process fair and transparent for everyone.

Protect Yourself from Scams. All official outreach comes from the Babylist Talent Team via @babylist.com email addresses only. We will never ask for payment or personal financial information. If you receive outreach via WhatsApp, Telegram, or a non-Babylist email, it's not us. Verify open roles at babylist.com/careers.

Apply once. Then go straight to the hiring manager.

After you apply, unlock the direct contact details of the people who actually make the call. A quick follow-up makes you 5x more likely to land an interview.

MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
Unlocked after you apply
·

Clinical Research Associate Related jobs

Other jobs at Babylist

Premium

Reach out to the hiring manager directly.

Gain access to the contact details of the hiring managers who actually decide, and reach out to network with them directly. That, plus more when you upgrade:

  • Full match report with fit score and gaps
  • Career diagnostics on how recruiters read you
  • Curated company matches and warm intros
  • 48h early access to new roles

Cancel anytime.