Provider Enrollment Manager Jobs

Resolution of Salesforce cases and management of issues and the team resolving the cases is a key element in this role.

Must be able to function independently, possess demonstrated flexibility in multiple project management

The Enrollment Specialist will manage all payer data in CredentialStream for both the group and the individual providers.

2+ years’ experience in payer enrollment function

Verity or other credentialing software experience preferred

Demonstrated skills in problem solving and analysis and resolution

• 2+ years of demonstrated management experience leading higher education enrollment teams.

REQUIRED KNOWLEDGE, SKILLS & ABILITIES

Perform personnel functions such as selection, training, evaluation, goal setting, performance management, corrective action, coaching, and mentoring.

Ensure service delivery by demonstrating effective time management and resource allocation including staff coverage.

• 4+ years’ experience within higher education enrollment.

O Consistent and compliant processes and procedures producing quality experience for students

Manage daily functions of their respective enrollment team.

Work with other managers to develop best practices.

Previous experience leading others and driving performance.

At least (4+) four years of work experience in customer service.

Working knowledge of Microsoft Office (Word, Excel, Power Point) and some Internet applications.

Excellent organizational and communication skills

Deep understanding of higher education admissions and enrollment management

3+ years of experience working in higher education

You’ll begin to use your experience and insights to help shape our products

You will have a deep knowledge of our product, company, and go-to-market strategies

Educational background in a communications, business, or quantitative field

Experience in a Customer Success role

Work with the Revenue Cycle Management team on any Credentialing related claim denials.

You’re a behavioral health credentialing expert. You’ve communicated with payors directly in the past, and you meet the following requirements:

Our dedication to mental health guides our culture. Wellness benefits include (but are not limited to):

Flexible working hours and location (remote OR in-office, your choice!)

In-office lunch and biweekly remote lunch on us!

Monitor the follow up process applications, and communicate with the payors directly to ensure that applications are staying on-track.

Two years of enrollment experience including Medicare and Medicaid experience.

ESSENTIAL DUTIES AND RESPONSIBILITIES (include but not limited to):

Maintain the accuracy of provider NPPES and CAQH accounts.

Populate and prepare enrollment applications for providers.

Responsible for following up on outstanding enrollment information and/or paperwork from providers.

Review provider applications for accuracy and completeness.

Maintains knowledge of current health plan and agency requirements for credentialing providers.

Tracks license and certification expirations for all providers to ensure timely renewals.

Excellent written and oral communication skills.

Strong organizational, problem-solving, and interpersonal skills.

Ability to manage priorities and workflow.

One to two years of related experience

Provide regular reporting to management on territory plans, sales activities, and referral volume and forecasts.

Familiarity with sales processes, and territory management

Build and manage a funnel of opportunities for referral from health systems and primary care providers within a specified territory.

Minimum 5 years of relevant work experience

Exceptional written and verbal communication skills

Experience with Salesforce or similar CRM system

2 years of experience in business environment.

Excellent verbal and written communication skills.

Proficiency in the use of Cactus credentialing software preferred.

High School diploma or equivalent

Proficient in the use of Excel.

Proficient in general computer software (Word, Outlook, PowerPoint).

Manage online and print ad placement for recruitment purposes

Host information sessions for interested candidates and present compelling information about Year Up’s program offerings

Manage the development and distribution of Year Up admissions collateral to local organizations

Create and manage the admissions calendar and ensure the implementation of all associated steps

Enter data, manage reports and ensure data integrity within Year Up’s national database (Salesforce.com)

3-5 years of professional experience preferred, preferably in recruitment, admissions, enrollment, and/or partnership development

Collaborate with team members, management and clients to resolve client inquiries; cross-train new resources in customer service processes

Provide knowledgeable responses to basic client questions; elevate more complex cases to appropriate staff as needed

2 or more years of customer service experience in any industry

Knowledge of basic help desk software, computer software and Microsoft Office applications

Strong problem-solving skills to bring inquiries to effective resolution

Strong customer service skills with an emphasis on written and oral communication to respond to inquiries professionally

2+years of Salesforce or CSM management

Experience training others, particularly for enrollment advisor or similar roles

Experience leading a continuous improvement process

Excellent written communication skills to ensure information continuity with Kidney Hero teams

Understand organizational, as well as patient needs and work with leadership to execute enrollment goals.

Enhance operational training and development process based on growth strategies

One (1) year of PIMS (Provider Information Management Systems) experience

Conduct training needs analysis based on quality control results. Recommend training materials and subject matter to management.

2 years of provider network enrollment/certification experience.

Bachelor's degree in any major. or 4 years of job-related work experience.

Our comprehensive benefits package includes:

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

Maintains up-to-date knowledge of regulations and policies related to provider enrollment

Provides guidance to providers on the enrollment process and requirements

Knowledge and understanding of the enrollment, credentialing and billing processes.

College education (degree a plus)

Computer skills and Excel, Word, Google Suite, Adobe DC Pro, and others

The individual will have excellent communication and documentation skills and be able to follow direction and instruction

5 + years of project management experience

Proven solid organizational and time management skills

Applies knowledge of provider enrollment business processes and areas of expertise relative to the enrollment and maintenance of Medicaid providers

Works with Project Manager to organize review of project information and documentation including Lessons Learned

5+ years of Medicaid experience

2+ years of provider enrollment experience

Support and comply with the company’s Quality Management System policies and procedures.

Develops the customer service and professional skills of team members to increase their value-add to the team and organization.

Manages and resolves customer complaints, identifies, and escalate priority issues while working collaboratively on the corrective action

Identifies and shares best practices and drives for continuous improvement of the customer experience.

Supervise staff including but not limited to organize and prioritize work, write/conduct performance reviews, train/develop, and manage work performance.

Excellent verbal and written English communication skills.

1-2 years of management experience required

Advanced computer skills, including proficiency in use of Google Suite, Salesforce, EHR/PM systems, and spreadsheet management.

You will join a completely remote team, and support our innovative, meaningful brand while working from home.

Directs the Enrollment team regarding the conduct of patient enrollment activities, manages day-to-day workflow and productivity

Demonstrates critical thinking skills in assessing and resolving daily operational difficulties and strategies of the call center.

3-5 years of experience in health care and enrollment required

Establishes close working relationships with Clients, Operations, and Revenue Cycle Management team

Bachelor’s Degree in Healthcare Administration, Business Administration, Benefits, or equivalent training and/or experience preferred

Manages the completion and submission of CMS Medicare, State Medicaid and any other third-party payer applications

At least one (1) year of provider enrollment experience preferred

Working knowledge of physician HIPAA Privacy & Security policies and procedures

Strong oral, written, and interpersonal communication skills

Will communicate with Managed Care on an ongoing basis as to status of payer contracts and other various enrollment issues.

Location FRANKLIN, TN (HR/PR Service Center)Full Time

Location FRANKLIN, TN (HR/PR Service Center)

Ensures the enrollment packets are appropriately signed, complete and accurate, and submitted to payer with necessary attachments, within Newport CARE system.

Coordinates re-enrollment dates and sends out application packets for all practitioners who require re-enrollment.

Tracks all steps taken in enrollment process and logs the actions in Newport CARE (the Credentialing database).