Provider Enrollment, Manager

Acentra Health; Atlanta (GA); On-site; USD 76,200 - 95,200; Full time

Job summary

Acentra Health in Georgia seeks a Provider Enrollment Manager to lead provider enrollment operations and recruitment efforts. You will maintain databases, interface with clients, and manage a team to meet program deliverables.

Qualifications include 5+ years in healthcare leadership, CMS enrollment knowledge, and Excel proficiency, with a Bachelor's degree preferred. This role emphasizes HIPAA compliance and timely execution.

Qualifications

• High School diploma or GED; Bachelor's degree preferred.
• Resident of Georgia.
• 5+ years in healthcare organization leadership (Payer).
• 2+ years' experience with healthcare system design, development and implementation (DDI).
• 3+ years leading provider enrollment operations.
• Knowledge of CMS enrollment requirements and payor regulations.
• Proficient in Microsoft Excel and Microsoft Office applications.
• Strong customer service skills.

Responsibilities

• Oversee provider recruitment and enrollment programs for the Open card FFS program.
• Maintain communication with payer representatives to ensure correct enrollment.
• Respond to provider requests and clarify requirements.
• Maintain multiple databases tracking enrollment data.
• Manage confidential information with discretion and HIPAA compliance.
• Lead a team of up to 15 coordinators and specialists.
• Meet deadlines and ensure contract deliverables.
• Read and adhere to corporate policies including HIPAA.

Skills

Leadership experience

Customer service

Excel proficiency

Education

High School diploma or GED

Bachelor's degree preferred

Tools

Microsoft Excel

Job description

Job Summary

Acentra Health is looking for a Provider Enrollment Manager to join our growing team.

The Provider Enrollment Manager oversees daily provider network and recruitment operations, keeping internal databases updated, interfacing with clients, understanding requirements and responsibilities, and general program management.

Responsibilities

• Oversee provider recruitment, enrollment, maintenance program for OHA Open card FFS program
• Maintain constant and open communication with payer representatives to ensure that providers enroll correctly.
• Respond to provider requests, issues, inquiries and clarify requirements.
• Maintain multiple internal and external databases to keep track of provider and payer enrollment data.
• Manage confidential information with discretion.
• Establish protocols and minimize potential revenue delays or losses as the main point of contact for providers going through the provider enrollment process.
• Keep application information up to date in the organization's system.
• Manage information and documentation, including provider newsletters, provider materials, and onsite provider meetings or trainings.
• Maintain confidentiality.
• Ensure that the program's services meet or exceed contract deliverables.
• Meet mandatory deadlines and project standards.
• Manage a team of up to 15, multi-disciplinary coordinators, Provider Education Specialist, Provider Enrollment, and Provider Relations Specialists
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Qualifications

• High School diploma or GED (Bachelor's degree is preferred)
• Resident of State of Georgia
• 5+ years' diverse, leadership experience in a healthcare organization (Payer)
• 2+ years' experience with healthcare system design, development and implementation (DDI)
• 3+ years leading provider enrollment operations, service delivery
• Knowledge of provider enrollment requirements for government agencies (CMS), payor organizations, and insurance regulations.
• Proficient in Microsoft Excel, and other Microsoft Office applications.
• Strong customer service skills.

Preferred Qualifications

• PMP is preferred
• Bachelor's degree in Healthcare Administration, Healthcare Management, or general Business Administration or related field of study (preferred)

Experience in Lieu of Degree

For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands‑on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree.

Compensation

USD $76,200.00 - USD $95,200.00 /Yr.

EEO

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or local law.