Medicaid Provider Enrollment Lead, Data & Compliance

Jobtailor; Springfield (IL); On-site; USD 80,000 - 110,000; Full time

Job summary

Jobtailor in the United States (Illinois) seeks a supervisor-level professional to lead the Special Enrollments Unit. The role focuses on provider enrollment, credentialing, and database oversight within a large medical health plan context.

Responsibilities include policy interpretation, data element enhancements for provider databases, and ensuring compliance with state and federal mandates. Strong leadership and data management skills are essential.

Qualifications

• Four-year college degree or equivalent.
• Three years of administrative experience in public or business organizations.
• Three years of provider enrollment/credentialing experience.
• Three years of experience with MMIS, provider databases, or data warehouses.
• Ability to use state-issued equipment (laptop).
• Background check and disclosure of criminal history.
• Authorized to work in the United States full-time.

Responsibilities

• Plan, direct, and evaluate the Special Enrollments Unit for the Bureau.
• Serve as a working supervisor.
• Develop and review studies to implement new data elements for the Provider Database.
• Interpret Medicaid policies for staff, the medical community, and other agencies.
• Organize and manage Provider Database records for new providers.

Skills

Provider Enrollment

Medicaid Policy Interpretation

Database Management

Administrative Experience

Staff Supervision

Education

Four-year college degree

Tools

MMIS

Provider Database

Data Warehouse Database

Job description

Jobtailor in the United States (Illinois) seeks a supervisor-level professional to lead the Special Enrollments Unit. The role focuses on provider enrollment, credentialing, and database oversight within a large medical health plan context.

Responsibilities include policy interpretation, data element enhancements for provider databases, and ensuring compliance with state and federal mandates. Strong leadership and data management skills are essential.