Supervisor, Provider Enrollment

MedAmerica•Sacramento, CA

2d•$31 - $39•Remote

About The Position

Vituity is seeking a Supervisor, Provider Enrollment to join their team. This role is remote and nationwide. The company's purpose is to improve lives by transforming healthcare. Vituity fosters a "culture of brilliance" where team accomplishments are valued, and success comes through shared purpose. They have opportunities at 890 practices across the country, serving 14.5 million patients annually. The company emphasizes that employees can take their job with them if they need to move.

Requirements

High school diploma or equivalent required.
1-2 years of experience leading projects/teams in healthcare required.
5 years of experience in healthcare with a thorough understanding of payers and provider enrollment process required.
Ability to interact effectively with practitioners, insurance representatives, internal departments, and team members.
Proficiency with Microsoft Office, with a high degree of speed and accuracy in typing
Strong attention to detail
Strong time management and organization required.
Strong interpersonal skills, ability to work as part of a team.
Strong problem resolution skills
Ability to effectively interact with providers, payer representatives, internal departments, team members, and other stakeholders, both in written and verbal communication
Proficient in Microsoft Office Suite (Teams, Outlook, PowerPoint, Word, Excel, OneNote, OneDrive)
Knowledge of laws and regulations regarding enrollment processing in multiple states
Knowledge of online Medicare/MediCal/Medicaid enrollment system, Identify & Access system, Counsel For Affordable Quality Healthcare system, Medicare enrollment specialties and National Provider Identifier taxonomies.
Knowledge of Salesforce (including Data Loader, DDP, and reporting).
Ability to accomplish tasks thoroughly and accurately.
Ability to effectively manage time and organize.
Knowledge of Medicaid enrollment process, including revalidations, medical license expirations, deactivations, NPI taxonomy importance, how data flows to Medicaid managed cares, Medicaid billing manual, state administrative codes, border state enrollment process, out of state enrollment process.
Knowledge of billing processes, including timely filing and claims denial reasons.
Demonstrate strong project management skills, including formal usage of project management tools, Utilizing Responsible Accountable Consultant Informed (RACI) and other project management techniques, agendas, action item lists, project checklist, desired outcomes, measures of success.
Utilize strong critical thinking skills to deeply analyze problems and find a timely solution with the best chance of long term success.

Nice To Haves

Bachelor’s degree preferred.
Experience and demonstrated ability with Provider Enrollment functions in a healthcare setting preferred.
Working knowledge of Salesforce, Provider Enrollment, Chain, and Ownership System (PECOS); Council for Affordable Quality Healthcare (CAQH); and Provider Application and Validation for Enrollment (PAVE) preferred.
Billing or reimbursement experience preferred.

Responsibilities

Participates in the selection, hiring, onboarding, and training of new employees.
Partners with other Provider Enrollment Supervisors, Managers, and Sr. Director to provide ongoing guidance, assistance, and coaching to the team.
Evaluates team performance and discusses career goals with each team member, promoting professional growth, development, and education.
Uses relationship-building, communication, coaching, and development skills to lead a remote team while maintaining focus on Vituity culture, team connection, and high performance.
Helps support excellent time management and preparedness by assisting the team with scheduling tasks out a minimum of 4 weeks into the future.
Oversees a team that processes provider enrollment for a specific clinical service, geographic market, or function.
Monitors and audits the preparation, submission, and approval of subteam’s provider enrollment applications.
Maintains strong knowledge of payer processes across multiple states.
Implements and maintains operational workflows, policies, standard operating procedures, and necessary documentation practices.
Consistently uses department and individual performance reports to ensure the team is performing at optimum levels.
Analyzes issues, diagnoses problems, and identifies process improvement opportunities to propose solutions.
Utilizes and trains subteam on multiple Salesforce functions, including Data Loader, Dynamic Document Package (DDP), dashboards, and reporting.
Uses multiple platforms such as SharePoint, Wrike, Teams, and Outlook as needed.
Project manages new startups and opportunities, attending internal startup calls and identifying areas of concern.
Researches new payer requirements to help the team implement new provider enrollment processes and workflows.
Maximizes team resources and workflows to increase efficiency and productivity.
Understands revenue cycle process and how provider enrollment impacts Vituity revenue.
Reinforces best practice deadlines to reduce A/R aging so that siteline revenue is received quicker.
Develops trending reports to identify areas of opportunity and plans, evaluates, and improves business processes.
Identifies and researches payer issues proactively and collaborates with RCM Denial Team on any payer or reimbursement issues due to provider enrollment.
Builds partnerships and relationships with payers across the nation.
Collaborates with Vituity Client Service Managers, Payer Contracting team members, site leadership, and other stakeholders.
Works and communicates cross functionally with other department supervisors.
Plans and leads internal team meetings and records meeting minutes.
Reports difficulties, obstacles, risks, and delays in enrollment to Vituity leadership.
Complies with federal, state, and national regulations and requirements.
Analyzes and reviews the language of new payer enrollment requirements and ensures requirements are communicated downstream.
Uses knowledge of Vituity Legal and Finance data to report changes in entity structure or finances to payers.
Keeps current on provider enrollment trends and attends state and national PE conferences as needed.

Benefits

Superior health plan options
Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%25 plus discretionary profit-sharing contributions
Generous paid time off starting 3-4 weeks’ annually
Student Loan Refinancing Discounts
Professional and Career Development Program
EAP and travel assistance included
Wellness program
Purpose-driven culture focused on improving the lives of our patients, communities, and employees
Annual corporate Success Sharing bonus program