Director - Provider Enrollment

Job Summary:

- Under administrative direction, the Director of Provider Enrollment oversees the Provider Enrollment team and the day-to-day Enrollment operations.

Essential Functions and Tasks:

- Direct, lead, and manage the Provider Enrollment departments day-to-day operations, recruits, selects, orients, trains, coaches, counsels, and disciplines staff.

- Develop relationships with the Provider Enrollment teams and documents needs and organizational priorities.

- Ensure success of the provider enrollment lifecycle by monitoring client level metrics as well as ensuring timeliness and accuracy of teams enrollment activities related to new enrollment, reenrollment, enrollment denials and client level special projects.

- Develop relationships with clients and provide regular status updates on credentialing related deliverables.

- Makes recommendations on work-flow processes throughout the enrollment cycle to assist in achieving consistency and success.

- Develop and make recommendations on policies, guidelines, and implement procedures to ensure consistent department-wide implementation and adherence.

- Hold monthly (or as warranted) meetings with all levels of management to review held claims, status of client provider enrollment, overall provider enrollment inventory, etc.

- Monitor timeliness and effectiveness of department activities, implement processes to identify gaps.

- Compile and prepares a variety of reports for management in order to analyze trends and make recommendations.

- Perform special projects and other duties as assigned.