Provider Enrollment, Manager

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

Benefits offered by this job

Health plans

Paid time off

Retirement savings

Corporate wellness

Educational assistance

Job summary

Acentra Health, based in Georgia, is seeking a Provider Enrollment Manager to oversee daily provider network operations, enrollment activities, and client interfaces within the OHA Open Card FFS program.

You will lead a team of up to 15 coordinators, ensure accuracy in enrollment data, HIPAA compliance, and timely delivery of contract obligations, leveraging your 5+ years of healthcare payer leadership.

Qualifications

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

Responsibilities

• Oversee provider recruitment, enrollment and maintenance for the OHA Open Card FFS program.
• Maintain communication with payer representatives to ensure correct provider enrollment.
• Respond to provider requests and clarify requirements.
• Manage databases tracking provider and payer enrollment data.
• Lead a team of up to 15 coordinators and specialists.
• Ensure HIPAA privacy and security compliance.
• Meet deadlines and contract deliverables.

Skills

Leadership

Customer service

Excel

Education

High School diploma or GED

Bachelor's degree preferred

Tools

Microsoft Excel

Microsoft Office

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, inviting employees to embrace the mission, actively engage in problem‑solving, and take ownership of their work every day.

Job Summary & Responsibilities

Acentra Health is looking for a Provider Enrollment Manager to join our growing team. The manager will oversee daily provider network and recruitment operations, maintain internal databases, interface with clients, and manage the program overall.

Responsibilities

• Oversee provider recruitment, enrollment, and maintenance for the OHA Open Card FFS program.
• Maintain constant and open communication with payer representatives to ensure correct provider enrollment.
• Respond to provider requests, issues, and inquiries, clarifying requirements.
• Maintain multiple internal and external databases to track provider and payer enrollment data.
• Manage confidential information with discretion.
• Establish protocols to minimize potential revenue delays or losses as the main contact for providers.
• Keep application information up to date in the organization’s system.
• Manage information and documentation, including provider newsletters, materials, and onsite meetings or trainings.
• Ensure program services meet or exceed contract deliverables.
• Meet mandatory deadlines and project standards.
• Manage a team of up to 15 coordinators and specialists across provider education, enrollment, and relations.
• Read, understand, and adhere to all corporate policies, including HIPAA and its Privacy and Security Rules.

Qualifications

• High School diploma or GED (Bachelor's degree is preferred).
• Resident of the State of Georgia.
• 5+ years of diverse, leadership experience in a healthcare organization (payer).
• 2+ years of experience with healthcare system design, development, and implementation (DDI).
• 3+ years leading provider enrollment operations and 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 certification is preferred.
• Bachelor’s degree in Healthcare Administration, Healthcare Management, Business Administration, or a related field (preferred).

Benefits

Our benefits are designed to provide additional protection, security, and support for both career and life away from work. They include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

EEO Statement

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, veteran status, or any other status protected by applicable federal, state, or local law.

Experience In Lieu Of Degree

For non‑clinical roles, or when not required by contract, practical experience can substitute for formal education. Six (6) years of directly relevant professional experience may be accepted in lieu of a bachelor’s degree; three (3) years may be accepted for an associate’s degree.

Compensation

The pay range for this position is USD $76,200.00 – USD $95,200.00 per year, based on experience and skill level.