Director, Enrollment & Provider Data Management (Remote)

Samaritan Health Services; Corvallis (OR); On-site; USD 90,000 - 130,000; Full time

Job summary

Samaritan Health Plans is seeking a senior leader to direct Enrollment and Provider Data Management across health plan lines, ensuring accurate enrollment, eligibility, and provider data maintenance. The role requires strategic oversight, cross‑functional collaboration, and compliance with CMS and state regulations.

The position emphasizes operational excellence, performance measurement, and partnerships with internal teams and external stakeholders to enhance patient and provider experiences.

Qualifications

• Bachelor's degree in healthcare administration, business, information systems, public health, or related field.
• Five (5) years of health plan operations experience.
• Three (3) years of leadership experience.
• Experience in Medicare Advantage, Medicaid, and Commercial health plan operations.
• Experience managing regulatory compliance, audits, and operational reporting.
• Experience with enrollment platforms, provider data systems, claims systems, and healthcare technology applications.
• Project management, process improvement, or Lean practices.

Responsibilities

• Provide leadership, strategic direction, and operational oversight for Enrollment and Provider Data Management across health plan lines (Commercial, Medicare, Medicaid).
• Ensure accurate and timely member enrollment and eligibility maintenance; provider data management and directory accuracy; regulatory compliance.
• Lead operational teams, develop business processes, monitor performance metrics, and collaborate with stakeholders to support organizational goals.

Skills

Leadership

Regulatory compliance

Process improvement

Critical thinking

Communication

Enrollment systems

Provider data

Claims systems

Healthcare technology

Project management

Education

Bachelor's degree in related field

Tools

Enrollment platforms

Provider data systems

Claims systems

Healthcare technology apps

Job description

Samaritan Health Plans is seeking a senior leader to direct Enrollment and Provider Data Management across health plan lines, ensuring accurate enrollment, eligibility, and provider data maintenance. The role requires strategic oversight, cross‑functional collaboration, and compliance with CMS and state regulations.

The position emphasizes operational excellence, performance measurement, and partnerships with internal teams and external stakeholders to enhance patient and provider experiences.