Provider Enrollment, Manager

Acentra Health, LLC•UNAVAILABLE, Georgia

19h

About The Position

Acentra Health is looking for a Provider Enrollment Manager to join their growing team. The Provider Enrollment Manager will oversee daily provider network and recruitment operations, keep internal databases updated, interface with clients to understand requirements and responsibilities, and manage the overall program. This role is crucial for ensuring providers enroll correctly, responding to their inquiries, and maintaining program services to meet or exceed contract deliverables. The manager will also be responsible for leading a team of up to 15 individuals, including coordinators and specialists, and ensuring adherence to all corporate policies, including HIPAA.

Requirements

High School diploma or GED
Resident of State of Georgia
5+ years' diverse, leadership experience in a healthcare organization (Payer)
2+ years' experience with healthcare system design, development and implementation (DDI)
3+ years leading provider enrollment operations, service delivery
Knowledge of provider enrollment requirements for government agencies (CMS), payor organizations, and insurance regulations.
Proficient in Microsoft Excel, and other Microsoft Office applications.
Strong customer service skills.

Nice To Haves

PMP is preferred
Bachelor’s degree in Healthcare Administration, Healthcare Management, or general Business Administration or related field of study (preferred)

Responsibilities

Oversee provider recruitment, enrollment, maintenance program for OHA Open card FFS program
Maintain constant and open communication with payer representatives to ensure that providers enroll correctly.
Respond to provider requests, issues, inquiries and clarify requirements.
Maintain multiple internal and external databases to keep track of provider and payer enrollment data.
Manage confidential information with discretion.
Establish protocols and minimize potential revenue delays or losses as the main point of contact for providers going through the provider enrollment process.
Keep application information up to date in the organization's system.
Manage information and documentation, including provider newsletters, provider materials, and onsite provider meetings or trainings.
Maintain confidentiality.
Ensure that the program's services meet or exceed contract deliverables.
Meet mandatory deadlines and project standards.
Manage a team of up to 15, multi-disciplinary coordinators, Provider Education Specialist, Provider Enrollment, and Provider Relations Specialists
Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules