Provider Enrollment Manager: Operations & Compliance

Boston Children's Hospital; Boston (MA); On-site; USD 110,000 - 150,000; Full time

Benefits offered by this job

Flexible schedules

Health, vision and dental insurance

Child care subsidies

Student loan subsidies

Generous paid time off

Retirement plan (401(k)/403(b)

Tuition reimbursement

License and certification assistance

Cell phone plan discounts

Transit/ticket discounts

Job summary

Boston Children's Hospital seeks a Manager of Provider Enrollment to lead enrollment across BCH, the Physicians' Organization and Franciscan Children's Hospital. This role ensures timely, accurate enrollment with insurers, Medicaid programs, and licensing authorities while guiding the enrollment team and coordinating with clinical leaders for efficient operations.

The role requires strong regulatory knowledge, process improvement skills, and leadership to drive compliant enrollment and optimized

Qualifications

• Associate degree required; Bachelor's preferred.
• Minimum of 3 years of provider enrollment experience.
• Knowledge of applicable state and federal laws governing hospitals, providers, and billing practices.
• Familiarity with Massachusetts insurance market.
• Experience leading enrollment teams and managing priorities.

Responsibilities

• Oversee provider and facility enrollment across BCH and partners.
• Manage enrollment with contracted plans and Medicaid programs.
• Maintain relationships with plans and ensure NCQA and regulatory compliance.
• Collaborate with leaders to improve enrollment processes and outcomes.
• Lead the enrollment team: hiring, training, performance, and workforce planning.
• Monitor staffing levels and budget alignment with organizational standards.
• Develop educational materials on enrollment processes for enterprise use.

Skills

Team leadership

Regulatory knowledge

Process improvement

Project management

Communication

Analytical thinking

Attention to detail

Stakeholder management

Problem solving

Education

Associate degree

Bachelor's degree

Tools

Enrollment software

Microsoft Office

Job description

Boston Children's Hospital seeks a Manager of Provider Enrollment to lead enrollment across BCH, the Physicians' Organization and Franciscan Children's Hospital. This role ensures timely, accurate enrollment with insurers, Medicaid programs, and licensing authorities while guiding the enrollment team and coordinating with clinical leaders for efficient operations.

The role requires strong regulatory knowledge, process improvement skills, and leadership to drive compliant enrollment and optimized