Director - Provider Enrollment - Healthcare (5-10 yrs)

Under administrative direction, the Director of Provider Enrollment oversees the Provider Enrollment team and the day-to-day Enrollment operations.

Essential Functions and Tasks:

1. Direct, lead, and manage the Provider Enrollment department's day-to-day operations, recruits, selects,orients, trains, coaches, counsels, and disciplines staff

2. Develop relationships with the Provider Enrollment teams and documents needs and organizational priorities

3. Ensure success of the provider enrollment lifecycle by monitoring client-level metrics as well as ensuring timeliness and accuracy of team's enrollment activities related to new enrollment, enrollment, enrollment denials and client-level special projects

4. Develop relationships with clients and provide regular status updates on credentialing-related deliverables

5. Makes recommendations on work-flow processes throughout the enrollment cycle to assist in achieving consistency and success

6. Develop and make recommendations on policies, guidelines, and implement procedures to ensure consistent department-wide implementation and adherence

7. Hold monthly (or as warranted) meetings with all levels of management to review held claims, status of client provider enrollment, overall provider enrollment inventory, etc.

8. Monitor timeliness and effectiveness of department activities, implement processes to identify gaps

9. Compile and prepare a variety of reports for management in order to analyze trends and make recommendations

10. Perform special projects and other duties as assigned

Education and Experience Requirements:

1. Bachelor's Degree in Healthcare Administration, Business Administration, Benefits, or equivalent training and/or experience preferred

2. At least five (5) years of physician billing, hospital billing, or vendor management experience in provider enrollment functions

3. At least two (2) years of supervisory/management/leadership experience preferred

4. Experience with the CAQH database, NPI website, and maintaining EDI, EFT, and ERA processes preferred