Director of Payer Enrollment

Assured•New York, NY

2d•$115,000 - $135,000

About The Position

The Director of Payer Enrollment provides strategic leadership for the full payer enrollment team, including commercial enrollment, government enrollment in partnership with the Government PE Manager, and contracting. The Director owns team-wide enrollment metrics and is accountable for turnaround, quality, and rework. This role brings executive-level presence to customer relationships, leads enrollment strategy for strategic customers, and partners with Operations, Sales, Customer Success, Product Development, and Leadership. The Director oversees contracting and payer enrollment operations, develops strategies and workflows to reduce enrollment cycle time and reimbursement delays, and ensures compliance with applicable regulations, accreditation standards, and payer requirements. The role owns payer enrollment tooling and systems strategy, establishes SOP and quality standards, builds unified QA and SLA visibility across customers, and leads process improvement. The Director also prepares executive reporting, serves as a subject matter expert on enrollment policies and regulations, leads pre-contract discovery and customer escalations, and builds the payer enrollment team's structure, roles, training, and SME capacity.

Requirements

Track record scaling payer enrollment or operations at a large provider organization; ideally at PE-backed provider groups or scaled digital health or health tech companies.
Experience leading managers and multifunctional teams.
Executive-facing customer experience.
Deep understanding of provider enrollment processes and regulations.
Familiarity with CAQH, PECOS, NPPES, and commercial payer systems.
Strong project management, analytical, and problem-solving skills.
Excellent verbal and written communication skills.
Ability to manage multiple priorities and deadlines.
Proficiency in healthcare software systems and Microsoft Office Suite.
Experience handling customer escalations and demonstrating executive presence.
A clear management philosophy and approach to team organization.
Experience building and refining SOPs and quality standards.
Customer enrollment strategy experience.
Metrics-driven management using data or BI tools.

Nice To Haves

Experience with automation or AI agents, including knowing when not to use them.

Responsibilities

Own turnaround, quality, and rework across commercial enrollment, government enrollment, and contracting.
Oversee the Contracting team, including timely implementation and receipt of customer health plan contracts, process reviews, and customer communications.
Develop and implement strategies and workflows to reduce enrollment cycle time and minimize reimbursement delays.
Establish and maintain relationships with commercial and government payers.
Ensure compliance with applicable regulations, accreditation standards, and payer-specific requirements.
Track KPIs for turnaround, quality, rework, denial rates, and provider participation.
Collaborate with Credentialing, Licensing, Sales, Customer Success, and Product Development teams.
Own the payer enrollment tooling and systems strategy, while the team operates those systems day to day.
Set the SOP template and quality bar, prioritize customer SOPs, and maintain a North Star enrollment strategy for each customer.
Build a unified QA and SLA view across customers.
Identify process improvements and lead initiatives to optimize payer enrollment operations.
Prepare and present regular reports to executive leadership on enrollment status, trends, and challenges.
Serve as a subject matter expert on Medicare, Medicaid, and commercial payer enrollment policies and regulations.
Lead pre-contract discovery and executive customer strategy, including enrollment strategy for strategic customers and handling escalations.
Build the payer enrollment team structure, roles, training, and SME team.