Payor Enrollment Manager - Credentialing & Onboarding

Munson Healthcare; Traverse City (MI); On-site; USD 75,000 - 115,000; Full time

Job summary

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.

Qualifications

• 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.

Responsibilities

• 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

Job description

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.