Manager, Payor Enrollment

Munson Healthcare•Traverse City, MI

About The Position

The Manager, Payor Enrollment oversees the payer enrollment team, which is responsible for system-wide enrollment of providers, facilities, pharmacies, durable medical equipment (DME), and related entities. The manager collaborates with credentialing, onboarding/provider relations, medical staff services, and operational leadership to ensure efficient and compliant enrollment throughout the credentialing and onboarding process. The role leads and coordinates payor enrollment activities, serves as the primary escalation point for complex enrollment and credentialing issues, monitors enrollment operations, and works with health plans and internal teams to resolve challenges and support compliant provider onboarding.

Requirements

Bachelor’s degree required.
At least five years of experience in physician services, revenue cycle, or another healthcare-related field required.
Knowledge of payor requirements required.

Nice To Haves

Three years of management or leadership experience preferred.
Knowledge of NCQA credentialing standards preferred.
Ability to interpret data within computerized information systems preferred.

Responsibilities

Lead and coordinate payor enrollment activities, ensuring timely submissions, approvals, and maintenance of active provider enrollments.
Serve as the primary escalation point for complex enrollment and credentialing issues; partner with health plans to resolve challenges and implement solutions.
Monitor enrollment operations, including status updates, team inquiries, audits, KPI reporting, and final review of payer submissions.
Collaborate with credentialing, onboarding, revenue cycle, and operational teams to support provider onboarding and enrollment compliance.
Work with relevant teams to resolve enrollment-related denials and underpayments.