Medicaid Program Manager 2 (Medicaid Provider Enrollment Manager)

State of Louisiana•Baton Rouge, LA

About The Position

The Provider Enrollment Manager oversees Louisiana Medicaid’s provider enrollment program and ensures compliance with federal and state provider enrollment requirements. The role provides operational oversight of the state’s contracted enrollment vendor and Medicaid staff responsible for provider screening, enrollment, revalidation, disclosures, and provider maintenance activities. It serves as a subject matter expert on Medicaid provider enrollment policy and works with CMS, providers, managed care organizations, licensing boards, and internal stakeholders to support efficient enrollment operations. The position is located in Medical Vendor Administration / Program Operations and Compliance in East Baton Rouge Parish. It may be filled as a probationary, promotional, job, or detail-to-special-duty appointment.

Requirements

Meet one of the following minimum qualification pathways: seven years of qualifying experience developing, managing, or evaluating health or social service programs, or in public health, public relations, social services, health services, health regulation, or administrative services; or six years of full-time work experience in any field plus four years of qualifying experience in those areas; or a bachelor’s degree plus four years of qualifying experience in those areas; or an advanced degree or Juris Doctorate plus three years of qualifying experience in those areas.
Experience substitution: Each 30 semester hours earned from an accredited college or university counts as one year toward the six years of full-time work experience in any field, up to 120 semester hours (four years).

Nice To Haves

Experience in Medicaid, healthcare administration, provider enrollment, program integrity, or related healthcare operations.
Knowledge of Medicaid provider enrollment requirements and healthcare regulatory compliance.
Experience managing contracts, vendor relationships, and complex operational programs.
Strong analytical, organizational, and problem-solving skills.
Ability to interpret regulations, develop policy, and implement operational improvements.
Excellent written and verbal communication skills.
Experience managing projects, stakeholders, and professional staff.
Commitment to improving program performance and provider experience.

Responsibilities

Oversee Louisiana Medicaid’s provider enrollment program and contracted enrollment vendor.
Monitor compliance with federal and state requirements, including provider screening, disclosures, revalidation, enrollment moratoria, and program integrity initiatives.
Develop, interpret, and implement provider enrollment policies, procedures, and operational guidance.
Oversee contractor performance, service level agreements, operational metrics, and corrective action activities.
Coordinate provider enrollment initiatives, system enhancements, federal mandates, and policy changes.
Collaborate with program integrity, legal, audit, compliance, managed care, and operational teams on enrollment issues and investigations.
Serve as a liaison with CMS, providers, managed care organizations, licensing boards, and other stakeholders.
Analyze operational data and performance trends to improve efficiency, compliance, and provider experience.
Prepare reports, presentations, policy memoranda, and executive briefings for agency leadership.
Supervise professional staff, set performance expectations, conduct evaluations, and provide coaching and development.
Manage special projects and perform other duties as assigned to support the Section’s goals and operations.