Provider Enrollment Manager - Department Promotion

We need to output HTML fragment with sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. Must not repeat job title. Must not include boilerplate like EEO, application instructions, etc. Must preserve all substantive info. We need to parse the description. Key info: - Under general direction of and in cooperation with the Director of Heath Care Agency (HCA) Medical Staff Administration, the Provider Enrollment Manager will oversee the systems for third party plan payor enrollments throughout the HCA. - IDEAL CANDIDATE: effective manager, professional demeanor, strong communication, interpersonal, administrative/office skills, substantial experience with third party payor enrollments and interpreting practitioner and payor contracts. - EDUCATIONAL/BILINGUAL INCENTIVE: Possible educational incentive of 2.5%, 3.5%, or 5% based on completion of Associate's, Bachelor's, or Master's degree. Incumbents may also be eligible for bilingual incentives depending upon operational need and certification of skill. - PAYROLL TITLE: Program Administrator II (management classification, not eligible for overtime). Incumbents eligible for benefits at MB4 level. - AGENCY/DEPARTMENT: Health Care Agency – Ventura County Medical Center/Santa Paula Hospital - Eligible list may be used to fill current and future Regular, Temporary, Fixed-term, Intermittent, or Extra Help vacancies for this position only. There is currently one (1) Full-time Regular vacancy. - TENTATIVE SCHEDULE OPENING DATE: 9/28/2026 CLOSING DATE: 10/9/2026 - Examples Of Duties: list of duties. - Typical Qualifications: entrance requirements: DEPARTMENT/AGENCY SERVICE: Currently working as a Regular employee for the County of Ventura Health Care Agency. (definition of Regular employee). EDUCATION, TRAINING, And EXPERIENCE: Considerable administrative skills coupled with some experience in provider enrollment which demonstrate possession of and competency in the required knowledge, skills and abilities. Example: Four (4) years of experience with administrative functions, including experience with the life cycle of provider enrollment and/or provider credentialing. Necessary Special Requirements: Intermediate skills with Microsoft Word and Excel; Effective communication as demonstrated by application and supplemental question responses. DESIRED: Experience with provider enrollment and/or provider credentialing within a public health care system, such as hospitals, clinics, or other health care organizations. Experience using online provider enrollment and credentialing databases and portal systems, such as MD-Staff, PAVE (Medi-Cal), and PECOS (Medicare). Experience in preparing professional reports and documentation. NAMSS certification in one of the following: CPCS, CPES, PESC. Willingness to obtain a relevant professional certification within two (2) years of becoming eligible to sit for the examination. Knowledge of: medical staff organization and health plan provider enrollment functions. Ability to: interpret and implement health plan accreditation and contract requirements; research and implement current best practices; utilize credentialing software programs; plan, organize, and supervise the work of others; build and maintain effective professional relationships with others; and communicate effectively in an oral and written manner. Skill in: Microsoft Word, Excel, and online portal database systems. - Recruitment Process etc: we need to drop application instructions, etc. - Benefits: "Your Benefits As a County Of Ventura Employee MANAGEMENT To learn more about Benefits, Retirement, and the Memorandum of Agreement (MOA), see links below. Benefits website or you may call (805) 654-2570. Retirement FAQ's Memorandum of Agreement Union Codes: MB3, MB4, MS, MT, MCC, MU". Also earlier: "Incumbents in these classifications are eligible for benefits at the MB4 level." So we have benefits info. - Pay: Not explicitly given a salary range. There's educational incentive percentages but not base pay. No explicit pay. So we should NOT create Pay section unless posting actually states them. It does not state a salary. So omit Pay. - Schedule: Not given specific schedule (full-time regular). It mentions "Full-time Regular vacancy". Could infer schedule full-time but not explicit hours. The rule: never create Schedule section unless posting actually states them. It does not state schedule details like shift, hours. So omit Schedule. - Benefits: we have some content: eligible for benefits at MB4 level, plus description of benefits website etc. So include Benefits section. - About the role: we can include the first paragraph about overseeing systems for third party plan payor enrollments. - Responsibilities: list of duties from Examples Of Duties. - Requirements: maybe combine Typical Qualifications (entrance requirements) and Necessary Special Requirements? Could be Requirements section. - Qualifications: maybe include DESIRED qualifications? But we need to avoid duplication. The instruction: Prefer a few substantive sections over many thin ones. We can have About the role, Responsibilities, Requirements (including education/experience, necessary special requirements), Qualifications (maybe desired/experience), Skills, Benefits. But we must not create sections with filler. Ensure each section has real content. Let's extract: About the role: "Under general direction of and in cooperation with the Director of Heath Care Agency (HCA) Medical Staff Administration, the Provider Enrollment Manager will oversee the systems for third party plan payor enrollments throughout the HCA." Responsibilities: list from Examples Of Duties: - Manages/oversees the provider enrollment operations with private and government payors; - Oversees the efficiency and accuracy of the provider enrollment vendor activities and billing processes; - Oversees the monthly health plan rosters and timely communication of roster changes; - Manages and maintain database provider enrollment records in MDStaff; - Collaborate with the Hospital Medical Staff credentialing team regarding provider data necessary for timely payor enrollments; - Monitors and investigates payor denials related to enrollments and roster discrepancies; - Develops/manages department enrollment policies & procedures; - Manages distribution and attestation process of health plan specific orientation/training requirements; - Maintains documents related to enrollments and the provider enrollment applications; - Manages the annual provider certificates of insurance in collaboration with the Agency’s malpractice carrier; - Drafts database enrollment related reports to support the enrollment process; - Creates accounts related to Practitioner Cerner HNAuser and Bedrock; - Supervise and trains administrative support staff; - Performs other related duties as required. We need to keep as list items. Requirements: Entrance requirements: DEPARTMENT/AGENCY SERVICE: Currently working as a Regular employee for the County of Ventura Health Care Agency. (definition). EDUCATION, TRAINING, And EXPERIENCE: Considerable administrative skills coupled with some experience in provider enrollment which demonstrate possession of and competency in the required knowledge, skills and abilities. Example: Four (4) years of experience with administrative functions, including experience with the life cycle of provider enrollment and/or provider credentialing. Necessary Special Requirements: Intermediate skills with Microsoft Word and Excel; Effective communication as demonstrated by application and supplemental question responses. We could combine these into Requirements. Qualifications: DESIRED: Experience with provider enrollment and/or provider credentialing within a public health care system, such as hospitals, clinics, or other health care organizations. Experience using online provider enrollment and credentialing databases and portal systems, such as MD-Staff, PAVE (Medi-Cal), and PECOS (Medicare). Experience in preparing professional reports and documentation. National Association of Medical Staff Services (NAMSS) certification in one of the following: Certified Provider Credentialing Specialist (CPCS), Certified Provider Enrollment Specialist (CPES), Provider Enrollment Specialist Certificate (PESC). Willingness to obtain a relevant professional certification within two (2) years of becoming eligible to sit for the examination. Knowledge of: medical staff organization and health plan provider enrollment functions. Ability to: interpret and implement health plan accreditation and contract requirements; research and implement current best practices; utilize credentialing software programs; plan, organize, and supervise the work of others; build and maintain effective professional relationships with others; and communicate effectively in an oral and written manner. Skill in: Microsoft Word, Excel, and online portal database systems. But note that some of these overlap with Skills. We could separate Skills: Microsoft Word, Excel, online portal database systems. However the DESIRED includes skill in those. To avoid duplication, we could have Skills section list those, and Qualifications list experience, certifications, knowledge, abilities. But we need to ensure not to create thin sections. Let's decide: Sections: - About the role (paragraph) - Responsibilities (ul) - Requirements (ul or p) covering entrance requirements, education/experience, necessary special req. - Qualifications (ul) covering desired experience, certifications, knowledge, abilities. - Skills (ul) covering Microsoft Word, Excel, online portal database systems. - Benefits (p) covering MB4 level benefits, benefits website, phone. We must not include Pay or Schedule. Check for any other substantive info: educational/bilingual incentive: possible educational incentive of 2.5%, 3.5%, or 5% based on degree; bilingual incentives depending on operational need and certification. This is a substantive benefit/incentive. Should we include that in Benefits? Yes, it's a benefit/incentive. So Benefits section can include educational incentive and bilingual incentive. Also PAYROLL TITLE: Program Administrator II (management classification, not eligible for overtime). That's about pay classification but not salary. Could be considered under Benefits? Not exactly. Might be considered under Requirements? It's a job classification. Could be included in About the role? Might be better to include in Requirements as "Payroll Title: Program Administrator II (management classification, not eligible for overtime)". But the rule: do not put Job ID/requisition numbers as headings; but this is not a Job ID. It's a classification. It's substantive. We could include it in Requirements or About the role. Since it's about the position classification, maybe include in About the role? But About the role already short. Could add a sentence: "The position is classified as Program Administrator II, a management classification not eligible for overtime." That seems appropriate. Also AGENCY/DEPARTMENT: Health Care Agency – Ventura County Medical Center/Santa Paula Hospital. Could be in About the role. Also eligible list info: maybe not needed for core job description; it's about recruitment process. Could be omitted as it's procedural. Tentative schedule opening/closing dates: that's recruitment timeline, not job schedule. Could be omitted as it's application instruction. Thus final HTML:

About the role

Under general direction of and in cooperation with the Director of Heath Care Agency (HCA) Medical Staff Administration, the Provider Enrollment Manager will oversee the systems for third party plan payor enrollments throughout the HCA. The position is classified as Program Administrator II, a management classification not eligible for overtime, within the Health Care Agency – Ventura County Medical Center/Santa Paula Hospital.

Responsibilities

• Manages/oversees the provider enrollment operations with private and government payors
• Oversees the efficiency and accuracy of the provider enrollment vendor activities and billing processes
• Oversees the monthly health plan rosters and timely communication of roster changes
• Manages and maintains database provider enrollment records in MDStaff
• Collaborates with the Hospital Medical Staff credentialing team regarding provider data necessary for timely payor enrollments
• Monitors and investigates payor denials related to enrollments and roster discrepancies
• Develops and manages department enrollment policies & procedures
• Manages distribution and attestation process of health plan specific orientation/training requirements
• Maintains documents related to enrollments and the provider enrollment applications
• Manages the annual provider certificates of insurance in collaboration with the Agency’s malpractice carrier