Provider Enrollment, Manager

Acentra Health, LLC; Georgia; On-site; USD 76,200 - 95,200; Full time

Benefits offered by this job

Health plans

Paid time off

Retirement savings

Educational assistance

Job summary

Acentra Health, LLC is seeking a Provider Enrollment Manager in Georgia to oversee daily provider network and recruitment operations, keeping databases updated and coordinating with clients.

The role requires 5+ years in healthcare leadership, plus 2+ years in system design and 3+ years leading enrollment operations. Strong Excel skills and knowledge of CMS regulations are essential.

Qualifications

• Bachelor's degree preferred or equivalent experience.
• 5+ years leadership experience in a healthcare organization (payer).
• 2+ years experience with healthcare system design, development and implementation.
• 3+ years leading provider enrollment operations and service delivery.
• Knowledge of provider enrollment requirements for government agencies (CMS) and payor regulations.
• Proficient in Microsoft Excel and other MS Office applications.

Responsibilities

• Oversee provider recruitment, enrollment, and maintenance for Open card FFS program.
• Maintain communication with payer representatives to ensure correct enrollment.
• Respond to provider requests, issues, inquiries, and clarify requirements.
• Maintain multiple internal and external databases to track provider and payer enrollment data.
• Manage confidential information with discretion and HIPAA compliance.
• Lead a team of up to 15 coordinators and specialists; ensure deadlines and standards.

Skills

Leadership experience

Healthcare payer knowledge

Project management

Customer service skills

Team management

Education

High School diploma or GED

Bachelor's degree preferred

Tools

Microsoft Excel

Job description

Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Summary

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

Job Summary: The Provider Enrollment Manager, your role involves overseeing daily provider network and recruitment operations keeping internal databases updated, interfacing with our client and understand the 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

Required 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.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

Pay Range: USD 76,200.00 - USD 95,200.00 /Yr.

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.