[Hiring] Manager, Provider Enrollment @Ventra Health

Role Description

The Manager, Provider Enrollment is primarily responsible for overseeing the Provider Enrollment Department.

• Manages Provider Enrollment Department operations; recruits, selects, orients, trains, coaches, counsels, and disciplines staff.
• Plans, monitors, appraises, and reviews staff job contributions.
• Implements cross functional training and succession planning as allowable.
• Develops relationship with clients and provides regular status updates on the credentialing process.
• Coordinates with client leadership and credentialing staff to obtain necessary documents and information for enrollment process.
• Holds monthly meetings with management to review held claims and address concerns.
• Reports major issues to MGA leadership and makes aware of potential threats/opportunities.
• Develops policies, guidelines, and implements procedures ensuring consistent department-wide implementation.
• Enhances and standardizes work-flow processes throughout the enrollment cycle.
• Monitors timeliness and effectiveness of department activities.
• Compiles and prepares reports for management to analyze trends and make recommendations.
• Conducts regular meetings with the team and provides suggestions for improvement.
• Protects and safeguards company and patient information; reports suspicious activity to 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 two (2) years of physician billing, hospital billing, or vendor management experience in provider enrollment functions.
• At least one (1) year of supervisory/management/leadership experience preferred.
• Experience with CAQH database, NPI website, and maintaining EDI, EFT, and ERA processes preferred.

Requirements

• 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 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.

Compensation

• Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.
• This position is also eligible for a discretionary incentive bonus in accordance with company policies.

Equal Employment Opportunity

Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.

Recruitment Agencies

Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.

Solicitation of Payment

Ventra Health does not solicit payment from our applicants and candidates for consideration or placement.

Attention Candidates

Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters. To protect yourself, verify any communication you receive by contacting us directly through our official channels.

Statement of Accessibility

Ventra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards.