Provider Enrollment, Manager

Job Summary and Responsibilities

The Provider Enrollment Manager oversees daily provider network and recruitment operations, keeps internal databases updated, interfaces with clients, understands requirements and responsibilities, and manages program management.

This role is remote, requires residency in the State of New Jersey. Responsibilities include:

• Establishing a Provider Enrollment operation/team, including Provider Enrollment/Credentialing, Call Center Services, Site Visits, Training/Outreach, Documentation/reference guides
• Demonstrated experience with excellent operational delivery, innovating through use of AI and automated tools
• Serve as primary point of contact for services, during DDI and Operational start-up activities
• Maintain strong client relationships
• Support hiring activities, build a strong team
• Oversee staff, productivity reporting, assure excellent contract/SLA performance, associated reporting/dashboards (including related design)
• Support documentation development, refinement and maintenance; including User and Procedure Manuals
• Manage escalations/urgent resolution matters
• Maintain confidentiality
• Ensure that the program's services meet or exceed contract deliverables
• Meet mandatory deadlines and project standards
• Manage a team of up to 15, multi-disciplinary coordinators, Provider Education Specialist, Provider Enrollment, and Provider Relations Specialists

Qualifications

• High School diploma or GED (Bachelor's degree is preferred)
• Resident of the State of New Jersey
• 5+ years' diverse, leadership experience in a healthcare organization (Payer)
• 2+ years' experience with healthcare system design, development and implementation (DDI)
• 3+ years leading provider enrollment operations, service delivery
• Knowledge of provider enrollment requirements for government agencies (CMS), payor organizations, and insurance regulations
• Proficient in Microsoft Excel, and other Microsoft Office applications
• Strong customer service skills

Preferred Qualifications

• PMP is preferred
• Bachelor’s degree in Healthcare Administration, Healthcare Management, or general Business Administration or related field of study (preferred)