Supervisor-Contracts and Enrollment (Full Time, Remote, North Carolina Based)

Alliance Health•Durham, NC

8d•$69,592 - $88,729•Remote

About The Position

The Supervisor of Contracts and Enrollment provides day-to-day oversight of all provider enrollment and contracting functions. The Supervisor of Contracts and Enrollment works with the Manager of Provider Contracts and Enrollment to implement all unit and departmental goals, and ensure internal and external requirements for provider contracting are met. This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into the Alliance Office for business and team meetings as needed.

Requirements

Bachelor’s degree from an accredited college or university in Human Services, Education, Sociology, Business, Public Administration, or related field
Four (4) years of experience in community, business, or governmental programs in health-related fields.
General knowledge of Provider Enrollment and Contract requirements
General healthcare and managed care knowledge
Knowledge of database systems for contract and claims management
Thorough knowledge of Microsoft Office Suite, particularly MS Word and MS Excel
Knowledge of NC Tracks enrollment requirements
Strong interpersonal skills and ability to communicate with various staff
Ability to problem solve
Ability to prepare reports
Ability to manage multiple tasks and/or projects

Nice To Haves

Supervisory experience in consultative, or administrative functions is preferred.
Prior experience in Managed Care setting, Provider Relations, or Provider Contracting preferred.

Responsibilities

Supervise day-to-day operations of the Enrollment and Contracting teams to ensure timely and accurate completion of all enrollment and contract requirements
Ensure all enrollment and contract processes are consistent across new and existing providers
Monitor Enrollment requests and responses to ensure compliance with internal policies and procedures
Support and oversee the assessment of provider applications to determine eligibility status for enrollment and contract, in line with network inclusion/exclusion criteria
Ensure provider contract set up is complete, accurate, and in alignment with all internal and external contracting requirements
Investigate provider service discrepancies in contract details, subsequent claims issues, and/or complaints as requested and report findings
Conduct Enrollment and Contracts quality audits
Ensure timely responses are provided for internal and external inquiries related to enrollment/contracting
Maintain all Contract and Enrollment desk procedures, reference materials, and workflows
Ensure staff are well trained in and comply with all organization and department policies, procedures, and business processes
Organize workflows and communicate updates to ensure all staff understand respective roles and responsibilities
Actively establish and promote a positive, diverse, and inclusive working environment that builds trust
Cultivate and encourage efforts to expand cross-team collaboration and partnership
Conduct team meetings and individual supervisory meetings as indicated
Serve as primary point of contact for escalated concerns related to a contract and/or enrollment status, including related claims issues
Investigate all concerns related to provider contracts or enrollment
Coordinate with internal departments to ensure provider contracting process is complete and timely, and does not negatively impact claims submission/payment
Coordinate special projects, contract changes, or other outreaches as assigned by Manager