Medicaid Provider Enrollment Program Lead

State of Louisiana; Baton Rouge (LA); Sur place; USD 90 000 - 125 000; Plein temps

Résumé du poste

The Louisiana Department of Health seeks a Provider Enrollment Manager to oversee Medicaid's provider enrollment program, ensuring compliance with federal and state requirements. You will work with CMS, licensing boards, and MCOs to optimize enrollment operations and policy guidance.

Qualifications include experience in Medicaid operations, contracts, and program management, with strong analytical and communication skills. Location: East Baton Rouge Parish, Baton Rouge, LA.

Qualifications

• Seven years of experience in developing, managing, or evaluating health or social service programs.
• Experience in Medicaid, healthcare administration, provider enrollment, or related healthcare operations.
• Knowledge of Medicaid provider enrollment requirements and healthcare regulatory compliance.
• Experience managing contracts, vendor relationships, and complex operational programs.
• Excellent written and verbal communication skills.
• Ability to interpret regulations and implement policy.

Responsabilités

• Provide oversight of Louisiana Medicaid's provider enrollment program and contracted enrollment vendor.
• Monitor compliance with federal and state provider enrollment requirements, including screenings and disclosures.
• Develop, interpret, and implement provider enrollment policies, procedures, and operational guidance.
• Oversee contractor performance, SLAs, operational metrics, and corrective actions.
• Coordinate implementation of provider enrollment initiatives and policy changes.
• Collaborate with program integrity, legal, audit, compliance, managed care, and operations teams.
• Serve as a liaison with CMS, providers, managed care organizations, licensing boards, and stakeholders.
• Analyze operational data and trends to improve efficiency, compliance, and provider experience.
• Prepare reports, presentations, and executive briefings for agency leadership.
• Supervise professional staff, set performance expectations, conduct evaluations, and coaching.
• Manage special projects and other duties to support the Section.

Connaissances

Healthcare program management

Medicaid/provider enrollment knowledge

Contract/vendor management

Policy interpretation

Analytical skills

Staff coaching

Description du poste

The Louisiana Department of Health seeks a Provider Enrollment Manager to oversee Medicaid's provider enrollment program, ensuring compliance with federal and state requirements. You will work with CMS, licensing boards, and MCOs to optimize enrollment operations and policy guidance.

Qualifications include experience in Medicaid operations, contracts, and program management, with strong analytical and communication skills. Location: East Baton Rouge Parish, Baton Rouge, LA.