About the role

  • Manage the end-to-end Medicaid provider enrollment process, ensuring compliance with CMS and state requirements
  • Day-to-day operations of the provider enrollment lifecycle including new enrollments, revalidations, and maintenance updates
  • Supervise staff performance to meet or exceed Service Level Agreements, turnaround times, and quality targets
  • Ensure compliance with state and federal regulations, manage team performance, and partner closely with clients and internal stakeholders to deliver accurate, timely, and high-quality enrollment processing
  • Utilize the Medicaid Management Information System (MMIS) as the system of record for updating provider data, uploading approved enrollment documents, and maintaining data accuracy
  • Oversee workflow and document processing using OnBase (Hyland) for document imaging, indexing, and secure storage
  • Use Verint Workforce Management (WFM) tools to monitor productivity, adherence, and staffing needs
  • Develop and maintain Standard Operating Procedures, training materials, and quality control procedures
  • Analyze trends and data to guide strategic planning and continuous improvement initiatives.

Requirements

  • Bachelor’s degree in healthcare administration, business administration, public health, or a related field
  • Minimum of five (5) years of experience in Medicaid provider enrollment, credentialing, or similar healthcare operations functions
  • At least three (3) years supervisory or management experience, leading teams in an operational or production-driven highly matrixed environment
  • Working knowledge of Medicaid Management Information Systems (MMIS) and Medicaid provider data standards
  • Exceptional written and oral communication and people skills.

Benefits

  • generous, flexible vacation policy
  • educational assistance
  • comprehensive health benefits
  • 401(k) employer match
  • leadership and technical development academies

Job title

Provider Enrollment Manager

Job type

Experience level

Mid levelSenior

Salary

$97,500 - $139,300 per year

Degree requirement

Bachelor's Degree

Location requirements

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