PROVIDER ENROLLMENT MANAGER

JOB DESCRIPTION

Responsible for determining and establishing all payor enrollment requirements for employed Nurse Practitioners and Physician Assistants and Collaborating Physicians. Responsible for supervising the Provider Enrollment Team in contracting, enrolling, and maintaining participation with governmental and commercial payors. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion and safety.

RESPONSIBILITIES

• Manage department priorities to address business and operational goals and challenges
• Deliver high quality service to operations team and ensure providers are enrolled with payors appropriately and timely
• Report team statuses and team metrics to senior leaders
• Ensure all required privileges are maintained 100% of the time
• Research and investigate complex enrollment and contracting issues
• Create relationships with internal and external stakeholders
• Measure and improve enrollment processes to minimize turnaround times
• Distribute assignments and monitor workload
• Develop policies and guidelines and ensure consistent department-wide implementation
• Manage the enrollment application process for the Providers and make them available for organizational leader review, revision, and approval prior to submission to the Agency
• Assist the Contracting team with initiating and executing payor contracts for individuals and groups
• Manage large amounts of information and documentation
• Run reports for weekly updates to management on enrollment and contracting statuses
• Work with the Accounts Receivable Senior Manager to resolve and avoid potential reimbursement issues
• Participate in various education/training as required
• Comply with HIPAA and Corporate Compliance program policies and other applicable corporate and departmental policies
• Always maintain privacy and confidentiality
• Perform other duties as assigned
• Must be able to perform the essential functions of this position with or without reasonable accommodation

• High School Diploma or GED
• 2+ years related experience required in provider enrollment, payor contracting or related field
• Thorough knowledge of reimbursement guidelines and medical terminology
• Strong analytical, organizational, computer, and excel skills
• Highly self-motivated with ability to work independently and with a team, prioritize, and handle multiple responsibilities to meet deadlines
• Ability to identify opportunities for process improvement and implement solutions
• Excellent presentation, oral, and written communication skills
• Attention to detail and ability to maintain a high degree of confidentiality
• Knowledge/understanding of healthcare compliance industry and federal laws/regulations
• Demonstrated coaching and influencing skills

• Bachelor's Degree