Director of Provider Enrollment & Network Readiness

E2E Alignment Healthcare USA, LLC; New York (NY); Hybrid; USD 126,000 - 190,000; Full time

Job summary

Alignment Health is seeking a Director of Provider Enrollment to lead end-to-end enrollment, delegated credentialing, and non-par provider management for our health plan. You will partner with Credentialing, Data Management, Claims, Compliance, and IT to ensure accurate onboarding and activation of providers.

The role requires extensive experience in provider enrollment operations, governance, and regulatory compliance, with a focus on efficiency, data integrity, and cross-functional

Qualifications

• Bachelor's degree in healthcare administration, Public Health, Business Administration, or related field.
• Master's degree is a plus.

Responsibilities

• Lead end-to-end provider enrollment from contract execution to activation.
• Oversee onboarding for contracted providers, facilities, IPAs, and delegated entities.
• Govern contract implementation workflows aligning contracting, credentialing, enrollment, and provider data.
• Ensure provider records are configured across downstream systems.
• Develop standardized enrollment procedures, controls, and QA processes.
• Manage delegated credentialing roster submissions and provider loads.
• Establish onboarding standards, loading protocols, and validation controls.
• Monitor registry accuracy, turnaround times, and SLA compliance.
• Provide oversight of non-participating and out-of-network provider enrollment.
• Lead data governance, validation, reconciliation, and audits.
• Support regulatory compliance and audit readiness.

Skills

Executive communication

Stakeholder management

Leadership

Regulatory compliance

Program governance

Education

Bachelor's degree in healthcare administration

Master's degree (preferred)

Job description

Alignment Health is seeking a Director of Provider Enrollment to lead end-to-end enrollment, delegated credentialing, and non-par provider management for our health plan. You will partner with Credentialing, Data Management, Claims, Compliance, and IT to ensure accurate onboarding and activation of providers.

The role requires extensive experience in provider enrollment operations, governance, and regulatory compliance, with a focus on efficiency, data integrity, and cross-functional