Provider Enrollment Advisor – Nevada

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

📋 Description

• Assist the Provider Enrollment Manager and team for Nevada Medicaid.

• Act as the subject matter expert regarding provider enrollment requirements.

• Ensure adherence to regulatory and business standards.

• Assess business needs and collect client requirements.

• Suggest process and system enhancements to support operational objectives.

• Create business specifications and work together with technical teams on system upgrades, testing, and implementation.

• Oversee project activities, timelines, and deliverables.

• Analyze data to identify trends, root causes, compliance risks, and opportunities for process improvement.

• Provide actionable recommendations.

• Support the development of corrective action plans.

• Resolve complex issues related to business applications.

• Establish stakeholder relationships and promote positive outcomes.

• Uphold accuracy and meticulous attention to detail.

⛳️ Requirements

• Bachelor’s degree in a relevant field or an equivalent combination of education, training, and experience.

• Five or more years of experience in healthcare operations (managed care, provider, or member services).

• Three or more years of experience in provider credentialing and enrollment.

• Five or more years of experience in problem-solving, research, and process improvement.

• Familiarity with provider enrollment processes and requirements for CMS Federal and State Guidelines related to enrollment and reenrollment policies is preferred.

• Knowledge of NV Medicaid Guidelines is preferred.

• Six Sigma Lean Green or Black Belt certification is preferred.

• Candidates must be available to work during business hours in the Pacific Time Zone.

🏝️ Benefits

• Work flexibility.

• Learning and career development opportunities.

• Generous and flexible vacation policy.

• 401(k) employer match.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.