Medicare Provider Enrollment Manager (HH & H)

WPS Health Solutions; Monona (WI); Remote; USD 85,000 - 110,000; Full time

Job summary

A leading not-for-profit health insurer in Madison, Wisconsin, is seeking a Medicare Provider Enrollment Manager to oversee team operations and ensure compliance with regulations. The ideal candidate should have extensive experience with Medicare enrollment processes and management skills. This role promotes a collaborative environment and offers remote work options. Competitive salary and comprehensive benefits are included.

Benefits

Performance bonus

401(k) matching

Health and dental insurance from DAY 1

Professional development programs

Competitive paid time off

Qualifications

• 5+ years of experience with Medicare Fee-for-Service provider enrollment operations.
• 3+ years of management or supervisory experience in related operations.
• Extensive knowledge of federal and state healthcare regulations.

Responsibilities

• Manage daily enrollment operations and coach team members.
• Analyze enrollment data for performance metrics and trends.
• Ensure regulatory compliance for credentialing and re-credentialing.

Skills

Excellent verbal and written communication skills

Strong analytical skills

Leadership and team-building capabilities

Knowledge of healthcare credentialing

Problem-solving abilities

Education

Bachelor's Degree in Business Administration or related field

Job description

Overview

Medicare Provider Enrollment Manager (HH & H – Home Health and Hospice) will lead supervisory and technical teams responsible for overseeing daily operations and functions related to provider enrollment. The role manages and streamlines processes, implements best practices to enhance efficiency, and ensures performance accountability. The Provider Enrollment Manager coaches, trains, recognizes, and evaluates associates to foster a productive team. As part of the Provider Enrollment Leadership team, the manager focuses on workflow management, action planning, and departmental initiatives.

Salary Range

85,000 ~110,000. The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, experience and may fall outside of this range.

Work Location

We are open to remote work in approved states: Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin.

What You Will Do

• Possess experience working with Medicare specifically in the Home Health and Hospice space.
• Manage and direct daily enrollment operations by providing guidance, coaching, and performance management to ensure accurate and timely completion of all aspects of the enrollment process.
• Organize, oversee, and manage all aspects of provider enrollment processes.
• Analyze enrollment data to track performance metrics and proactively identify trends.
• Lead in maintaining and adhering to all internal and external regulatory requirements for credentialing and re-credentialing, staying informed of enrollment requirements and industry best practices.
• Support and guide project inventory levels, ensuring production levels meet goals and internal controls are maintained.
• Oversee security responsibilities to protect company resources and data while ensuring privacy and confidentiality of Medicare data and employee information.
• Prepare and provide detailed management reports related to performance, staffing, budget, training, and resource needs.

Minimum Qualifications

• Bachelor's Degree in Business Administration, Healthcare Administration or related field, or equivalent combination of education and experience.
• 5 or more years of experience with Medicare Fee-for-Service provider enrollment operations.
• 3 or more years of management, supervisory, or team lead experience in Medicare Part A, Part B, or Home Health and Hospice operations.
• Extensive knowledge of healthcare credentialing and payer enrollment processes, including state and federal regulations.
• Excellent verbal and written communication skills with the ability to explain complex information effectively.
• Strong analytical, problem-solving, and organizational skills with the ability to manage multiple processes and meet tight deadlines.
• Demonstrated leadership and team-building capabilities.
• Ability to identify, prioritize, and drive work efforts that improve efficiency through innovation or process improvement.
• Ability to work in a complex, rapidly evolving environment with multiple internal and external stakeholders.

Preferred Qualifications

• CMS knowledge of the Home Health and Hospice program.
• Experience processing Home Health and Hospice provider enrollment applications.
• MAC contractor experience with FISS, MCS and PECOS systems.

Remote Work Requirements

• Wired internet connection from router to computer
• High speed cable or fiber internet
• Minimum of 10 Mbps downstream and at least 1 Mbps upstream

Benefits

• Remote and hybrid work options available
• Performance bonus and/or merit increase opportunities
• 401(k) with a 100% match for the first 3% of salary and a 50% match for the next 2% (100% vested immediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Professional and Leadership Development Programs
• Review additional benefits: see Company Benefits information

Who We Are

WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.

Culture Drives Our Success

WPS'' culture is the place where great work and innovations are seen, fueled and rewarded. We create an open and empowering employee experience, recognizing the value of employee engagement as an investment in our workforce to effectively seek, leverage, and include differing perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work in an organization that adapts to business changes and opportunities.

We are proud of the recognition we have received from local and national organizations regarding our culture and workplace.

Security and Compliance

This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). The role is subject to applicable federal regulations, CMS contract requirements, and WPS internal policies including data security, privacy, confidentiality, and program integrity. CMS contractors and personnel are subject to screening and background investigation prior to gaining access to information systems and sensitive data.

Equal Opportunity

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For more information, please review the Know Your Rights notice from the Department of Labor.