Director, Payer Enrollment & Managed Care Ops

Valley Health System; Paramus (NJ); On-site; USD 101,000 - 127,000; Full time

Benefits offered by this job

Medical, Dental & Vision

Group Life Insurance

Flexible Spending Accounts and Commutr

Disability & Legal Support

Paid Holidays & PTO

Retirement Plan

Tuition Assistance

Employee Assistance Program

Fitness Center Membership Discount

Day Care Discounts

Job summary

Valley Health System is seeking a Manager, Provider Enrollment and Managed Care Operations to lead payer relations, provider enrollment and delegated credentialing, translating strategy into compliant operational processes and ensuring timely, accurate execution.

You will oversee enrollment records, resolve enrollment issues, and serve as a key internal/external resource on insurance industry changes, coordinating with Revenue Cycle, Payer Analytics, Legal, Finance and clinical leadership to

Qualifications

• Bachelor's degree required.
• Minimum five years in managed care in a health care setting.
• Minimum three years in payer enrollment with delegated credentialing.

Responsibilities

• Oversee provider enrollment and delegated credentialing operations.
• Lead payer relations and payer strategy implementation.
• Ensure regulatory compliance and accurate enrollment records.
• Collaborate with Revenue Cycle, Legal, Finance and clinical leadership to implement payer strategies.

Skills

Leadership and team management

Managed care operations

Provider enrollment

Healthcare reimbursement

Strategic planning

Process improvement

Analytics

Regulatory compliance

Cross-functional collaboration

Communication skills

Education

Bachelor's degree

Job description

Valley Health System is seeking a Manager, Provider Enrollment and Managed Care Operations to lead payer relations, provider enrollment and delegated credentialing, translating strategy into compliant operational processes and ensuring timely, accurate execution.

You will oversee enrollment records, resolve enrollment issues, and serve as a key internal/external resource on insurance industry changes, coordinating with Revenue Cycle, Payer Analytics, Legal, Finance and clinical leadership to