Provider Enrollment Manager

📋 Description

• Provide exceptional service to operational teams, ensuring that providers are accurately and timely enrolled with payers.

• Supervise team priorities to achieve operational and business objectives, while tracking and reporting key performance metrics to leadership.

• Maintain all provider privileges to ensure they are current and compliant at all times.

• Investigate and resolve complex issues related to enrollment and contracting.

• Foster and sustain relationships with both internal stakeholders and external partners.

• Assess and enhance enrollment processes to minimize turnaround times.

• Allocate and balance team workloads while monitoring and guiding performance.

• Establish department policies and procedures for consistent application across the board.

• Manage enrollment applications and ensure provider review and approval before submission.

• Assist in the execution of payer contracts for both individuals and groups.

• Systematically organize and maintain large volumes of documentation.

• Deliver regular updates to management through comprehensive reports.

• Collaborate with the Revenue Cycle team to address held accounts receivable issues.

• Engage in educational and training initiatives to uphold compliance and quality standards.

• Guarantee adherence to HIPAA, Corporate Compliance, and confidentiality regulations.

• Lead staffing activities, including hiring, training, evaluating, and coaching team members.

• Set and monitor performance goals, ensuring team members are held accountable to established metrics.

• Conduct regular one-on-one meetings to foster awareness, engagement, and personal growth.

⛳️ Requirements

• A bachelor’s or associate degree is preferred; a high school diploma is mandatory.

• At least two years of experience in physician hospital credentialing or licensing is required.

• A solid understanding of medical terminology and payer regulations.

• Familiarity with governmental and commercial payer requirements, applications, and workflows.

• Experience with CAQH, PECOS, and State Medicaid portals is essential.

• Proficiency in Microsoft Word, Excel, Adobe, and credentialing software.

• Strong organizational abilities and keen attention to detail.

• Capacity to multitask, meet deadlines, and independently manage multiple priorities.

• A proactive mindset towards problem-solving and continuous quality improvement.

🏝️ Benefits

• Comprehensive health, dental, vision, life, and 401(k) benefits.

• Flexible vacation and wellness days.

• 100% remote work with a national impact and executive visibility.

• A culture that promotes ownership, transparency, and results.