Director, Provider Enrollment

Boston Children's Hospital; Westwood (MA); On-site; USD 150,000 - 210,000; Full time

Job summary

Boston Children’s Hospital is seeking a Director of Provider Enrollment to lead enrollment across the hospital, Physicians’ Organization, and related foundations. The role oversees Medicaid enrollment, ensures regulatory compliance, and partners with senior leaders to improve efficiency and outcomes.

The position requires extensive experience in provider enrollment, strong leadership and project management skills, and the ability to drive enterprise-wide initiatives.

Qualifications

• Bachelor’s degree required; Master’s degree in Healthcare Administration or related field preferred.
• Minimum of 8 years of related experience, including 5 years of progressive management experience.
• Strong working knowledge of provider enrollment principles, processes, and regulatory requirements.

Responsibilities

• Provides strategic direction and operational oversight for provider and facility enrollment across the enterprise.
• Oversees contracted payer, government, and out-of-state Medicaid enrollment activities, ensuring timely, accurate, and compliant submissions.
• Leads and develops the Provider Enrollment team, including managers and staff; establishes priorities, delegates effectively, develops talent, and fosters accountability and continuous improvement.
• Uses data, analytics, and performance metrics to identify opportunities, evaluate outcomes, and drive process improvements across provider enrollment functions.
• Leads strategic and tactical projects with enterprise-wide impact, managing multiple initiatives, timelines, resources, and stakeholder needs.
• Partners with PO Billing, Patient Financial Services, Government Relations, Payer Relations, Medical Staff Services, and other clinical and administrative leaders to improve enrollment processes and outcomes.
• Identifies opportunities to leverage technology and develop efficient, scalable models for provider enrollment across multiple entities.
• Develops, maintains, and implements policies, procedures, and governance related to provider enrollment.
• Oversees the Provider Enrollment budget and collaborates with leadership on staffing, resources, and strategic priorities.
• Collaborates with the Sr. Director, Medical Staff Services, to identify opportunities for process integration and improvement across related functions.
• Serves as a strategic partner to senior leaders, using sound judgment, analytical expertise, and cross-functional influence to address complex issues and support decision-making.

Skills

Leadership

Project management

Analytics

Communication

Influencing skills

Strategic thinking

Education

Bachelor’s degree

Master’s degree in Healthcare Administration

Job description

Position Summary

The Director of Provider Enrollment provides strategic and operational leadership for provider and facility enrollment across Boston Children’s Hospital, the Physicians’ Organization and its related foundations, and Franciscan Children’s Hospital. Reporting to the Senior Director, Professional Medical Staff Services, the Director oversees contracted, government, and out-of-state Medicaid enrollment for all billable providers and entities, ensuring compliance with applicable regulatory, state, and federal requirements. The Director leads a team responsible for timely, accurate, and comprehensive enrollment and develops strategies to improve efficiency, quality, and outcomes through data, technology, and continuous process improvement. This role will partner with senior leaders across Revenue Cycle, Patient Financial Services, Government Relations, Payer Relations, Medical Staff Services, and other areas to advance enterprise-wide initiatives and ensure effective provider enrollment processes.

Key Responsibilities

• Provides strategic direction and operational oversight for provider and facility enrollment across the enterprise.


• Oversees contracted payer, government, and out-of-state Medicaid enrollment activities, ensuring timely, accurate, and compliant submissions.


• Leads and develops the Provider Enrollment team, including managers and staff; establishes priorities, delegates effectively, develops talent, and fosters accountability and continuous improvement.


• Uses data, analytics, and performance metrics to identify opportunities, evaluate outcomes, and drive process improvements across provider enrollment functions.


• Leads strategic and tactical projects with enterprise-wide impact, managing multiple initiatives, timelines, resources, and stakeholder needs.


• Partners with PO Billing, Patient Financial Services, Government Relations, Payer Relations, Medical Staff Services, and other clinical and administrative leaders to improve enrollment processes and outcomes.


• Identifies opportunities to leverage technology and develop efficient, scalable models for provider enrollment across multiple entities.


• Develops, maintains, and implements policies, procedures, and governance related to provider enrollment.


• Oversees the Provider Enrollment budget and collaborates with leadership on staffing, resources, and strategic priorities.


• Collaborates with the Sr. Director, Medical Staff Services, to identify opportunities for process integration and improvement across related functions.


• Serves as a strategic partner to senior leaders, using sound judgment, analytical expertise, and cross-functional influence to address complex issues and support decision-making.

Required Qualifications

• Bachelor’s degree required; Master’s degree in Healthcare Administration or related field preferred.


• Minimum of 8 years of related experience, including 5 years of progressive management experience.


• Strong working knowledge of provider enrollment principles, processes, and applicable regulatory requirements.


• Demonstrated experience leading provider enrollment operations within a complex healthcare organization or multi-entity environment.


• Strong project management and organizational skills, with the ability to manage multiple priorities and enterprise-wide initiatives simultaneously.


• Demonstrated ability to use data and analytics to identify opportunities, solve complex problems, and drive process improvement.


• Strong leadership, communication, relationship-building, and influencing skills, with the ability to effectively engage senior leaders and diverse stakeholders.


• Demonstrated ability to navigate ambiguity, exercise sound judgment, set priorities, and make timely decisions.


• Ability to manage complex relationships with composure, interpersonal savvy, and strong listening skills.


• Certified Provider Enrollment Specialist (CPES) preferred.

The posted pay range is Boston Children’s reasonable and good-faith expectation for this pay at the time of posting.

Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors. Base pay is one part of a comprehensive benefits package that includes flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.