Director Of Operations

Manila Recruitment; Pampanga; On-site; PHP 1,800,000 - 3,000,000; Full time

Job summary

A healthcare staffing firm based in Pampanga is looking for a Director of Provider Enrollment. This role involves overseeing the daily operations of a team and ensuring compliance with provider enrollment processes. Candidates should have extensive experience in physician billing and vendor management. This position offers the chance to lead a sizable department in a dynamic environment.

Qualifications

• Preferred bachelor's degree in relevant fields.
• At least five years of experience in provider enrollment.
• Two years supervisory experience preferred.
• Bachelor’s Degree in Healthcare Administration or Business Administration preferred.
• Knowledge of provider enrollment requirements and multi-state operations.

Responsibilities

• Oversee Provider Enrollment team and daily operations.
• Develop client relationships and monitor enrollment activities.
• Ensure compliance with regulatory requirements.
• Provide regular status updates on credentialing deliverables to clients and management.
• Develop and refine policies, guidelines, and procedures for consistent enrollment processes.
• Prepare management reports and lead special projects as assigned.

Skills

Provider enrollment knowledge

Supervisory skills

Healthcare data analysis

Interpersonal communication

Problem-solving skills

Organizational skills

Time management skills

Education

Bachelor’s Degree in Healthcare Administration or Business

High School diploma or equivalent

Tools

CAQH database experience

NPI website knowledge

EDI, EFT, and ERA processes

Job description

The posted salary is not the actual salary, as it remains confidential. Salary and compensation details will be discussed during the interview process.

Company Profile

• Our client is a revenue cycle management organization dedicated to serving hospital-based providers. The organization aims to deliver world-class, technology-enabled revenue cycle management and business solutions.
• Their specialties include Anesthesia and Emergency Medicine Revenue Cycle Management, Advisory Solutions for Practice Management, Hospital and Health System Consulting, RCM for Hospital-Based Specialties, and general Advisory Solutions.

Overview

• The role of the Director of Provider Enrollment involves overseeing daily operations, managing a team of approximately 100 people, and ensuring provider enrollment processes are efficient and compliant with payer networks.

Duties and Responsibilities

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 department’s 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 team’s 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
• 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.

Values

• Excellence:Encourage and promote excellence in partnering with and delivering results to our clients.
• Accountability:Accept responsibility for achieving objectives and key results and be answerable for outcomes.
• Teamwork:Embrace the power of one team to create and deliver value to clients by delivering consistent outcomes.
• Growth:Provide consistent opportunities for colleagues to expand their capabilities & knowledge.
• Transparency:Openly share ideas and information to promote trust, increase engagement and gain new perspectives.
• Inclusiveness & Diversity:Embrace and celebrate diversity and promote an environment of inclusiveness.
• Recognition:Acknowledge, embrace and celebrate colleague contributions that align with the company vision.
• Compliance:Ensure enterprise-wide adherence to regulatory requirements, ethical standards, and best practices

Education and Experience Requirements

• 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; The position requires experience in provider enrollment, particularly with denials and general RCM experience.
• 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.

Knowledge, Skills, and Abilities

• 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, and respond to questions from groups of executives, managers, clients, and customers.
• 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 to provide the best solution.
• 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.

Schedule: Monday to Friday, 8:00 PM to 5:00 AM Philippine time

Location:Clark, Pampanga