Provider Enrollment Manager - Department Promotion

County of Ventura; Ventura (CA); On-site; USD 90,000 - 110,000; Full time

Job summary

County of Ventura is seeking a Provider Enrollment Manager to oversee third party payor enrollments across the Health Care Agency. The role emphasizes leadership, collaboration with credentialing teams, and process improvement in a fast-paced public health setting.

The ideal candidate will combine administrative expertise with experience in provider enrollment and contract interpretation, ensuring accurate roster communications and compliant documentation.

Qualifications

• Strong communication, interpersonal, and administrative skills.
• Experience with third party payor enrollments and interpreting practitioner and payor contracts.
• Intermediate skills with Microsoft Word and Excel.

Responsibilities

• Manages/oversees provider enrollment operations with private and government payors.
• Oversees the efficiency and accuracy of provider enrollment vendor activities and billing processes.
• Oversees the monthly health plan rosters and timely communication of roster changes.
• Manages and maintains database provider enrollment records in MDStaff.
• Collaborates with the Hospital Medical Staff credentialing team for timely payor enrollments.
• Monitors and investigates payor denials related to enrollments and roster discrepancies.
• Develops/manages department enrollment policies & procedures.
• Manages distribution and attestation process of health plan specific orientation/training requirements.
• Maintains documents related to enrollments and provider enrollment applications.
• Manages annual provider certificates of insurance with the malpractice carrier.
• Drafts database enrollment related reports to support the enrollment process.
• Creates accounts related to Practitioner Cerner HNAuser and Bedrock.
• Supervise and trains administrative support staff.
• Performs other related duties as required.

Skills

Effective communication

Interpersonal skills

Administrative skills

Microsoft Word

Microsoft Excel

Provider enrollment knowledge

Tools

MDStaff

PAVE (Medi-Cal)

PECOS (Medicare)

Job description

Description

Under general direction of and in cooperation with the Director of Heath Care Agency (HCA) Medical Staff Administration, the Provider Enrollment Manager will oversee the systems for third party plan payor enrollments throughout the HCA.

IDEAL CANDIDATE

The ideal candidate will be an effective manager who maintains a professional, pleasant, and respectful demeanor with all levels of staff in a fast-paced environment. This person will have strong communication, interpersonal, and administrative/office skills, as well as substantial experience with third party payor enrollments and interpreting practitioner and payor contracts.

EDUCATIONAL/BILINGUAL INCENTIVE:

Possible educational incentive of 2.5%, 3.5%, or 5% based on completion of Associate's, Bachelor's, or Master's degree. Incumbents may also be eligible for bilingual incentives depending upon operational need and certification of skill.

PAYROLL TITLE:

Program Administrator II

Program Administrator II is a management classification and is not eligible for overtime compensation. Incumbents in these classifications are eligible for benefits at the MB4 level.

AGENCY/DEPARTMENT:

Health Care Agency – Ventura County Medical Center/Santa Paula Hospital

The eligible list established from this recruitment may be used to fill current and future Regular, Temporary, Fixed-term, Intermittent, or Extra Help vacancies for this position only. There is currently one (1) Full-time Regular vacancy.

TENTATIVE SCHEDULE

OPENING DATE: 9/28/2026

CLOSING DATE: 10/9/2026

Examples Of Duties

• Manages/oversees the provider enrollment operations with private and government payors;
• Oversees the efficiency and accuracy of the provider enrollment vendor activities and billing processes;
• Oversees the monthly health plan rosters and timely communication of roster changes;
• Manages and maintain database provider enrollment records in MDStaff;
• Collaborate with the Hospital Medical Staff credentialing team regarding provider data necessary for timely payor enrollments;
• Monitors and investigates payor denials related to enrollments and roster discrepancies;
• Develops/manages department enrollment policies & procedures;
• Manages distribution and attestation process of health plan specific orientation/training requirements;
• Maintains documents related to enrollments and the provider enrollment applications;
• Manages the annual provider certificates of insurance in collaboration with the Agency’s malpractice carrier;
• Drafts database enrollment related reports to support the enrollment process;
• Creates accounts related to Practitioner Cerner HNAuser and Bedrock;
• Supervise and trains administrative support staff;
• Performs other related duties as required.

Typical Qualifications

These are entrance requirements to the examination process and ensure neither continuance in the process nor placement on an eligible list.

DEPARTMENT/AGENCY SERVICE:

Currently working as a Regular employee for the County of Ventura Health Care Agency.

EDUCATION, TRAINING, And EXPERIENCE

Considerable administrative skills coupled with some experience in provider enrollment which demonstrate possession of and competency in the required knowledge, skills and abilities.

• Four (4) years of experience with administrative functions, including experience with the life cycle of provider enrollment and/or provider credentialing.

Necessary Special Requirements

• Intermediate skills with Microsoft Word and Excel
• Effective communication as demonstrated by application and supplemental question responses

DESIRED

• Experience with provider enrollment and/or provider credentialing within a public health care system, such as hospitals, clinics, or other health care organizations.
• Experience using online provider enrollment and credentialing databases and portal systems, such as MD-Staff, PAVE (Medi-Cal), and PECOS (Medicare).
• Experience in preparing professional reports and documentation.
• National Association of Medical Staff Services (NAMSS) certification in one of the following:
• Certified Provider Credentialing Specialist (CPCS)
• Certified Provider Enrollment Specialist (CPES)
• Provider Enrollment Specialist Certificate (PESC)
• Willingness to obtain a relevant professional certification within two (2) years of becoming eligible to sit for the examination.

Knowledge of:

medical staff organization and health plan provider enrollment functions.

Ability to:

interpret and implement health plan accreditation and contract requirements; research and implement current best practices; utilize credentialing software programs; plan, organize, and supervise the work of others; build and maintain effective professional relationships with others; and communicate effectively in an oral and written manner.

Skill in:

Microsoft Word, Excel, and online portal database systems.

Recruitment Process

Recruitment Process details are internal; requirements are stated above.

LATERAL TRANSFER OPTION:

If presently permanently employed in another \"merit\" or \"civil service\" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a \"merit\" or \"civil service\" style examination, then appointment by \"Lateral Transfer\" may be possible. If interested, please click here for additional information.

EQUAL EMPLOYMENT OPPORTUNITY

The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation.

Your Benefits As a County Of Ventura Employee

MANAGEMENT

To learn more about Benefits, Retirement, and the Memorandum of Agreement (MOA), see links below.

• Benefits website or you may call [phone].
• Retirement FAQ's
• Memorandum of Agreement

Union Codes: MB3, MB4, MS, MT, MCC, MU