Manager of Enrollment and Provider Data (Health Plans)

Samaritan Health Services; Corvallis (OR); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player in healthcare is seeking a Manager of Enrollment and Provider Data to lead the enrollment process and manage provider data. This remote role offers the chance to influence operations and enhance efficiency within a dynamic organization committed to building healthier communities. You will be responsible for developing policies, collaborating with teams for member retention, and ensuring compliance with healthcare regulations. If you're passionate about healthcare and possess strong leadership and critical thinking skills, this opportunity is perfect for you to make a significant impact.

Benefits

Starting bonus

Relocation assistance

Qualifications

• 3+ years experience in enrollment and/or provider data management in healthcare.
• 2+ years of progressive leadership experience required.

Responsibilities

• Manage member enrollment process and develop policies for efficiency.
• Oversee provider data management ensuring accuracy and compliance.

Skills

Leadership

Conflict resolution

Critical thinking

Communication

Education

Bachelor’s degree in Healthcare Administration

Master’s degree

Tools

Healthcare management systems

Data analytics tools

Job description

Manager of Enrollment and Provider Data (Health Plans)

Starting bonus and/or relocation available to new employees. Previous experience may be required. Employment commitment to Samaritan is required.

Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.

As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin.

Responsibilities

• Member Enrollment:
• Manages the member enrollment process, ensuring timely and accurate enrollment of new members and updates for existing members.
• Develops and implements enrollment policies and procedures to streamline operations and enhance efficiency.
• Monitors enrollment metrics and KPIs, identifying areas for improvement and implementing corrective actions.
• Collaborates with the marketing and outreach teams to support member acquisition and retention initiatives.
• Provider Data Management:
• Oversees the collection, validation, and maintenance of provider data, ensuring accuracy and completeness.
• Manages the provider data entry process, including updating existing provider information.
• Ensures provider data is compliant with regulatory standards and internal policies.

Experience/Education/Qualifications

Bachelor’s degree in Healthcare Administration, Business Administration, Information Management, or a related field; or equivalent experience required. Master’s degree preferred.

Three (3) years experience in enrollment and/or provider data management within a managed care organization or a similar healthcare setting required.

Two (2) years progressive leadership experience required.

Experience in healthcare regulations, including Medicare and Medicaid, required.

Experience in healthcare management systems and data analytics tools required.

Knowledge/Skills/Abilities

Leadership: Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.

Conflict resolution: Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.

Critical thinking: Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.

Communication and team building: Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.

Physical Demands

Rarely
(1 - 10% of the time)

Occasionally
(11 - 33% of the time)

Frequently
(34 - 66% of the time)

Continually
(67 – 100% of the time)

LIFT (Floor to Waist: 0"-36") 0-20 Lbs

LIFT (Knee to chest: 24"-54") 0 - 20 Lbs

LIFT (Waist to Eye: up to 54") 0 - 20 Lbs