Manager, Payor Enrollment

Munson Healthcare; Traverse City (MI); In loco; USD 75.000 - 115.000; Tempo pieno

Descrizione del lavoro

Munson Healthcare in northern Michigan seeks a Manager of Payor Enrollment to lead the payer enrollment team across system-wide provider enrollments, ensuring accuracy, timeliness and compliance in a complex network.

You will collaborate with credentialing, onboarding, revenue cycle and operational teams to resolve denials, optimize workflows, monitor KPI performance, and advance NCQA credentialing standards.

Competenze

• Minimum of five (5) years of experience in physician services, revenue cycle, or another healthcare-related field.
• Three (3) years of management or leadership experience preferred.
• Knowledge of payor requirements; NCQA credentialing standards and the ability to interpret data within computerized information systems preferred.

Mansioni

• Lead and coordinate all payor enrollment activities, ensuring timely submissions, approvals, and maintenance of active provider enrollments.
• Serve as the primary escalation point for complex enrollment and credentialing issues, partnering with health plans to resolve challenges and implement solutions.
• Monitor enrollment operations, including status updates, team inquiries, audits, KPI reporting, and final review of payer submissions.
• Collaborate with credentialing, onboarding, revenue cycle, and operational teams to support provider onboarding, enrollment compliance, and resolution of enrollment-related denials and underpayments

Descrizione del lavoro

Imagine doing meaningful work in a place where peoplevacation.That’slife at Munson Healthcare - northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties.

If you want a career in healthcare and alifestylemost people only dream about – with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be Munson Material.

Invested in You

Grow:Tuition reimbursement, in-person and onlinedevelopment,and access to ourcareer hubto help you advance.

Thrive:Full benefits, paid holidays,29 daysof PTO,management incentive program,employee discounts, and free individual retirement counseling.

Be Well:Freewellness platform for you and your family,pluspersonalizedsupport for personal or family challenges.

Be Heard:Share your ideas and help shape the way we work through improvement huddles, employee surveys, and town hall meetings

Job Description

The Manager, Payor Enrollment oversees the payer enrollment team, responsible for system-wide enrollment of providers, facilities, pharmacies, DME, and related entities. Collaborates with credentialing, onboarding/provider relations, medical staff services, and operational leadership to ensure efficient and compliant enrollment throughout the credentialing and onboarding process.

• Lead and coordinate all payor enrollment activities, ensuring timely submissions, approvals, and maintenance of active provider enrollments.
• Serve as the primary escalation point for complex enrollment and credentialing issues, partnering with health plans to resolve challenges and implement solutions.
• Monitor enrollment operations, including status updates, team inquiries, audits, KPI reporting, and final review of payer submissions.
• Collaborate with credentialing, onboarding, revenue cycle, and operational teams to support provider onboarding, enrollment compliance, and resolution of enrollment-related denials and underpayments

Qualifications

• Minimum of five (5) years of experience in physician services, revenue cycle, or another healthcare-related field required.
• Three (3) years of management or leadership experience preferred.
• Knowledge of payor requirements required; knowledge of NCQA credentialing standards and the ability to interpret data within computerized information systems preferred.

Munson Healthcare requires all employees be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella and Varicella. MHC also requires all employees to receive a flu vaccine during the flu season in the year that they are hired and annually thereafter, or receive an approved medical or religious exemption.