Payer Enrollment Supervisor

This is a fully remote position, open to applicants in United States.

📋 Description

• Manage the complete payer enrollment and maintenance lifecycle for both individual and group providers, encompassing initial enrollments, revalidations, re-credentialing-related activities, demographic updates, roster submissions, and other payer obligations.

• Lead, mentor, and assist payer enrollment staff by overseeing workload, providing training, conducting performance management, and performing quality reviews.

• Act as a subject matter expert on the requirements and participation standards for commercial payer enrollment.

• Offer guidance on complex enrollment issues and serve as an escalation point for problems involving payers, providers, and enrollment processes.

• Supervise ongoing maintenance of CAQH profiles and implement controls to track expirations and pending updates.

• Track enrollment applications, payer statuses, rosters, and effective dates to detect delays, discrepancies, and risks.

• Communicate directly with commercial payers to clarify requirements and resolve enrollment challenges.

• Collaborate with teams in Credentialing, Contracting, Compliance, Legal, Provider Operations, Revenue Cycle, Billing, and more.

• Ensure the accuracy of enrollment records and documentation across enrollment and provider data systems.

• Develop, implement, and enhance payer enrollment policies, procedures, workflows, and controls.

• Monitor and report on enrollment metrics, turnaround times, application statuses, CAQH maintenance, and other key performance indicators (KPIs).

• Drive process improvement and automation initiatives.

• Keep updated on payer requirements, CAQH processes, state and federal regulations, and industry best practices.

⛳️ Requirements

• Bachelor’s degree preferred (or equivalent professional experience).

• A minimum of 4 years of payer enrollment experience within a healthcare organization, medical group, health plan, hospital, CVO, or behavioral health environment.

• At least 2 years of experience in a leadership or supervisory capacity is preferred.

• Demonstrated ability to coach, ensure accountability, and lead a team in maintaining high standards for quality and timeliness.

• Extensive knowledge of commercial payer enrollment processes, provider participation requirements, roster management, revalidations, and platforms such as CAQH, NPPES, PECOS, payor portals, credentialing software, and ticketing systems (e.g., CredentialStream, Salesforce, Zendesk).

• Strong understanding of how credentialing, contracting, enrollment, and revenue cycle operations interrelate, along with a proven ability to scale and enhance operational workflows.

• Highly detail-oriented self-starter who effectively manages competing deadlines, drives process follow-through, and exercises sound judgment when addressing complex payer and provider escalations.

• Excellent analytical, organizational, and interpersonal skills to facilitate collaboration across departments, service lines, and leadership levels.

• Proven track record of building, improving, and scaling operational processes.

🏝️ Benefits

• Comprehensive healthcare coverage (including medical, dental, vision, FSA/HSA, life and disability insurances).

• Access to Lyra for Lyrians; coaching and therapy services.

• Equity in the company through discretionary restricted stock units.

• Competitive paid time off policies, including vacation, sick days, and company holidays.

• Paid parental leave.

• 401K plan with up to 3% matching.

• Monthly technology allowance.

• Well-being perks and activities.

• Surprise swag.

• Regular community celebrations.