Director, Payer Enrollment & Strategy

Assured; New York (NY); Sur place; USD 180 000 - 240 000; Plein temps

Résumé du poste

Assured is seeking a Director of Payer Enrollment to lead the full payer enrollment function, including commercial, government, and contracting streams. You will own turnaround, quality, and rework metrics while shaping enrollment strategy for strategic customers and partnering with Operations, Sales, Customer Success, Product Development, and Leadership.

The role requires executive presence, deep regulatory knowledge, and the ability to drive process improvements across multiple payer systems

Qualifications

• Track record scaling payer enrollment or operations at a large provider organization.
• Experience leading managers and multi-function teams.
• Executive-facing customer experience.
• Deep understanding of provider enrollment processes and regulations.
• Familiarity with CAQH, PECOS, NPPES, and commercial payer systems.
• Strong project management, analytical, and problem-solving skills.
• Excellent verbal and written communication.
• Ability to manage multiple priorities and deadlines.
• Proficiency in healthcare software systems and Microsoft Office Suite.
• Customer escalation handling and executive presence.

Responsabilités

• Own turnaround, quality, and rework across the full payer enrollment team (commercial, government, and contracting).
• Oversee the Contracting team, ensuring timely implementation and receipt of customer health plan contracts and clear communication with customers.
• Develop and implement strategies to reduce enrollment cycle time and minimize reimbursement delays.
• Establish and maintain strong relationships with commercial and government payers.
• Ensure compliance with regulations, accreditation standards, and payer requirements.
• Track KPIs for turnaround, quality, rework, denial rates, and provider participation.
• Collaborate with Credentialing, Licensing, Sales, Customer Success, and Product Development teams.
• Own payer enrollment tooling and systems strategy (Availity, CAQH, PECOS, CMS I&A, NPPES) and day-to-day operations.
• Set SOP templates and quality bars, prioritize customer SOPs, and maintain a North Star enrollment strategy for each customer.
• Build a unified QA and SLA view across customers.
• Identify process improvements and lead optimization initiatives.
• Prepare and present reports to executive leadership on status, trends, and challenges.
• Serve as SME on enrollment policies (Medicare, Medicaid, commercial).
• Lead pre-contract discovery and executive customer strategy for strategic customers; handle escalations.
• Build payer enrollment team structure, roles, training, and SME team.

Connaissances

Payer enrollment

Leadership

Executive presence

Regulatory knowledge

CAQH knowledge

Contracting experience

KPIs & analytics

Cross-functional

Project management

Communication

Outils

Availity

CAQH

PECOS

CMS I&A

NPPES

Description du poste

Assured is seeking a Director of Payer Enrollment to lead the full payer enrollment function, including commercial, government, and contracting streams. You will own turnaround, quality, and rework metrics while shaping enrollment strategy for strategic customers and partnering with Operations, Sales, Customer Success, Product Development, and Leadership.

The role requires executive presence, deep regulatory knowledge, and the ability to drive process improvements across multiple payer systems