[Hiring] Director of Provider Enrollment @Ventra Health

Role Description

Under administrative direction, the Director of Provider Enrollment is responsible for the strategic leadership and operational oversight of the Provider Enrollment function, including team performance, day-to-day enrollment activities, and the effective delivery of provider enrollment services.

• Directs, leads, and manages the Provider Enrollment department’s day to day operations.
• Recruits, selects, orients, trains, coaches, counsels, and disciplines staff.
• Develops relationships with the Provider Enrollment teams and documents needs and organizational priorities.
• Ensures success of the provider enrollment lifecycle by monitoring client level metrics.
• Ensures timeliness and accuracy of team’s enrollment activities related to new enrollment, reenrollment, enrollment denials, and client level special projects.
• Develops relationships with clients and provides regular status updates on credentialing related deliverables.
• Makes recommendations on work-flow processes throughout the enrollment cycle.
• Develops and makes recommendations on policies, guidelines, and implements procedures.
• Holds monthly (or as warranted) meetings with all levels of management.
• Monitors timeliness and effectiveness of department activities.
• Compiles and prepares a variety of reports for management.
• Performs special projects and other duties as assigned.

Qualifications

• High School diploma or equivalent.
• Bachelor’s Degree in Healthcare Administration, Business Administration, Benefits, or equivalent training and/or experience preferred.
• At least five (5) years of physician billing, hospital billing, or vendor management experience in provider enrollment functions.
• At least two (2) years of supervisory/management/leadership experience preferred.
• Experience with CAQH database, NPI website and maintaining EDI, EFT, and ERA processes preferred.

Requirements

• Knowledge of provider enrollment requirements for physician billing and multi-state experience preferred.
• Knowledge of business and financial processes, procedures, and processes.
• Knowledge of medical terminology and anatomy.
• Knowledge of requirements of medical record documentation.
• Strong supervisory/management skills.
• Strong leadership development and team building skills.
• Strong management level oral, written, and interpersonal communication skills.
• Strong financial reporting skills.
• Strong healthcare data analysis skills.
• Strong presentation development and delivery skills.
• Strong word processing, spreadsheet, database, and presentation software skills.
• Strong decision-making skills.
• Strong problem-solving skills.
• Strong organizational skills.
• Strong time management skills.
• Strong mathematical skills in addition, subtraction, multiplication and division of whole numbers and fractions; computing percentages, areas, and volumes; and working with decimals.
• Ability to effectively present information, including financial reporting and healthcare analytics.
• Ability to adapt communication style to suit different audiences.
• Ability to communicate with business stakeholders and IT staff in a tactful, mature, and professional manner.
• Ability to know how and when to involve key players and effectively use internal employer resources.
• Ability to initiate and maintain professional relationships.
• Ability to see reoccurring issues and fixing them or identify and solve front end issues.
• Ability to communicate with diverse personalities in a tactful, mature, and professional manner.

Benefits

• Eligible for Ventra performance-based incentive plan.
• Referral bonus for referring friends.